Umesh Goneppanavar, George Mathew, Venkateswaran Ramkumar
Department of Anaesthesiology, Kasturba Medical College, Manipal, Karnataka State, India.
Acta Anaesthesiol Taiwan. 2010 Sep;48(3):130-5. doi: 10.1016/S1875-4597(10)60044-6.
The jaw lift maneuver has been traditionally used to facilitate Trachlight-guided orotracheal intubation. The aim of this study was to compare the jaw lift maneuver with another potentially useful maneuver, tongue traction, for facilitating Trachlight-guided orotracheal intubation.
This study was prospective and randomized in design. A single experienced investigator performed Trachlight-guided orotracheal intubations in 100 adult patients with clinically normal airways undergoing elective surgeries under general anesthesia with paralysis. Patients were divided into two groups: Group J (jaw lift); and Group T (tongue traction using a padded artery forceps). Three parameters were recorded: search time (device insertion to midline glow); time to intubate (device insertion to glow at suprasternal notch); and time to confirm (device insertion to confirmation of placement by capnography).
All patients were intubated successfully using the Trachlight. Only one patient in Group J required more than two attempts for successful intubation. First and second attempt success rates were, respectively, 86% and 98% in Group J, and 92% and 100% in Group T. Mean search time, time to intubate and time to confirm were comparable: 6.36 ± 4.20 seconds, 11.23 ± 6.69 seconds and 21.59 ± 7.69 seconds, respectively, in Group J, and 6.81 ± 4.53 seconds, 10.79 ± 6.02 seconds and 22.80 ± 7.85 seconds, respectively, in Group T.
The tongue traction maneuver is as good as the jaw lift maneuver with regard to the success rate and time taken for Trachlight-guided orotracheal intubation.
传统上使用提颌手法来辅助Trachlight引导下的经口气管插管。本研究的目的是比较提颌手法与另一种可能有用的手法——舌牵引，用于辅助Trachlight引导下的经口气管插管。
本研究为前瞻性随机设计。一名经验丰富的研究者对100例气道临床正常、在全身麻醉下接受择期手术且使用肌肉松弛剂的成年患者进行Trachlight引导下的经口气管插管。患者分为两组：J组（提颌）；T组（使用带衬垫的动脉钳进行舌牵引）。记录三个参数：搜索时间（器械插入至中线发光）；插管时间（器械插入至胸骨上切迹发光）；确认时间（器械插入至通过二氧化碳描记法确认放置位置）。
所有患者均使用Trachlight成功插管。J组仅1例患者成功插管需要超过两次尝试。J组首次和第二次尝试成功率分别为86%和98%，T组分别为92%和100%。平均搜索时间、插管时间和确认时间相当：J组分别为6.36±4.20秒、11.23±6.69秒和21.59±7.69秒，T组分别为6.81±4.53秒、10.79±6.02秒和22.80±7.85秒。
在Trachlight引导下的经口气管插管成功率和所需时间方面，舌牵引手法与提颌手法效果相当。
