Stroumpoulis Konstantinos, Pagoulatou Alexandra, Violari Magda, Ikonomou Irini, Kalantzi Nausika, Kastrinaki Kalliopi, Xanthos Theodoros, Michaloliakou Christina
Department of Anaesthesiology, 'Metaxa' Cancer Hospital of Piraeus, Greece.
Eur J Anaesthesiol. 2009 Mar;26(3):218-22. doi: 10.1097/EJA.0b013e32831c84d1.
Several studies have shown that videolaryngoscopes can provide better laryngeal exposure than conventional laryngoscopy. These studies, however, did not exclusively focus on patients with an anticipated difficult intubation. The aim of the present study was to assess whether a videolaryngoscope would provide better laryngeal exposure than conventional laryngoscopy and therefore facilitate intubation in cases of difficult laryngoscopy.
One hundred and twelve patients with an estimated difficult intubation, scheduled to undergo surgical operations, requiring general anaesthesia and endotracheal intubation, were included in the study. Direct laryngoscopy with a Macintosh blade was performed, followed by videolaryngoscopy and intubation attempt(s). The laryngeal views obtained by each method were recorded according to the Cormack/Lehane scale.
The percentage of Cormack-Lehane I and II views obtained by conventional laryngoscopy rose from 63.4 to 90.2% (P < 0.0005) with videolaryngoscopy, whereas Cormack-Lehane III and IV views declined from 36.6 to 9.8% (P < 0.0005). Intubation was successful in 98.2% of the cases.
In patients with an anticipated difficult airway, videolaryngoscopy significantly improved the laryngeal exposure thus facilitating endotracheal intubation.
多项研究表明，视频喉镜比传统喉镜能提供更好的喉部视野暴露。然而，这些研究并非专门针对预计插管困难的患者。本研究的目的是评估视频喉镜是否比传统喉镜能提供更好的喉部视野暴露，从而在喉镜检查困难的情况下便于插管。
本研究纳入了112例预计插管困难、计划接受外科手术、需要全身麻醉和气管插管的患者。先用麦金托什喉镜进行直接喉镜检查，随后进行视频喉镜检查并尝试插管。根据Cormack/Lehane分级记录每种方法获得的喉部视野。
传统喉镜检查获得的Cormack-Lehane I级和II级视野百分比从63.4%升至视频喉镜检查时的90.2%（P<0.0005），而Cormack-Lehane III级和IV级视野从36.6%降至9.8%（P<0.0005）。插管成功率为98.2%。
对于预计气道困难的患者，视频喉镜显著改善了喉部视野暴露，从而便于气管插管。
