Anesthesiology Department, University Hospital Center and University of Lausanne, Lausanne, Switzerland.
Acta Anaesthesiol Scand. 2010 Jan;54(1):55-8. doi: 10.1111/j.1399-6576.2009.02119.x. Epub 2009 Sep 17.
Tracheal intubation may be more difficult in morbidly obese (MO) patients than in the non-obese. The aim of this study was to evaluate clinically if the use of the Video Intubation Unit (VIU), a video-optical intubation stylet, could improve the laryngoscopic view compared with the standard Macintosh laryngoscope in this specific population.
We studied 40 MO patients (body mass index >35 kg/m(2)) scheduled for bariatric surgery. Each patient had a conventional laryngoscopy and a VIU inspection. The laryngoscopic grades (LG) using the Cormack and Lehane scoring system were noted and compared. Thereafter, the patients were randomised to be intubated with one of the two techniques. In one group, the patients were intubated with the help of the VIU and in the control group, tracheal intubation was performed conventionally. The duration of intubation, as well as the minimal SpO(2) achieved during the procedure, were measured.
Patient characteristics were similar in both groups. Seventeen patients had a direct LG of 2 or 3 (no patient had a grade of 4). Out of these 17 patients, the LG systematically improved with the VIU and always attained grade 1 (P<0.0001). The intubation time was shorter within the VIU group, but did not attain significance. There was no difference in the SpO(2) post-intubation.
In MO patients, the use of the VIU significantly improves the visualisation of the larynx, thereby improving the intubation conditions.
与非肥胖患者相比，病态肥胖（MO）患者的气管插管可能更困难。本研究的目的是评估在这种特殊人群中，视频插管装置（VIU），一种视频光学插管管芯，是否可以改善喉镜检查视野，与标准的 Macintosh 喉镜相比。
我们研究了 40 名接受减肥手术的 MO 患者（体重指数>35 kg/m²）。每位患者均进行了常规喉镜检查和 VIU 检查。记录并比较了使用 Cormack 和 Lehane 评分系统的喉镜分级（LG）。然后，将患者随机分为两组进行插管。一组患者使用 VIU 进行插管，另一组患者使用常规方法进行插管。测量插管时间和过程中最低 SpO2。
两组患者的特征相似。17 名患者的直接 LG 为 2 或 3（无患者的 LG 为 4）。在这 17 名患者中，LG 系统地随着 VIU 的使用而改善，并且始终达到 1 级（P<0.0001）。VIU 组的插管时间较短，但未达到显著性差异。插管后 SpO2 无差异。
在 MO 患者中，使用 VIU 可显著改善喉部可视化，从而改善插管条件。
