Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg 21, D-24105 Kiel, Germany.
Anesth Analg. 2011 Feb;112(2):382-5. doi: 10.1213/ANE.0b013e31820553fb. Epub 2010 Dec 14.
In the present preliminary study we evaluated the C-MAC® D-Blade (Karl Storz, Tuttlingen, Germany), a new videolaryngoscopic C-MAC blade for difficult intubation, during both routine and difficult intubations. First, both the conventional direct laryngoscopy and the D-Blade were used in 15 consecutive patients with normal airways during routine induction of anesthesia. Second, the D-Blade was used as a rescue device in 20 of 300 (6.7%) consecutive patients, when conventional direct laryngoscopy failed. In the 15 patients during routine induction of anesthesia, with direct laryngoscopy, a Cormack-Lehane (C/L) grade 1 and grade 2a view was seen in 7 and 8 patients, respectively. It was possible to insert the D-Blade and to get a video view of the glottis on the first attempt in all patients; with the D-Blade, all 15 patients had a C/L 1 view. The time to successful intubation with the D-Blade was 15 (8-26) seconds (median (range)). In the 20 patients, in whom unexpected difficulty with direct laryngoscopy was observed, C/L grades 3 and 4 were present in 15 and 5 patients, respectively. With the use of the D-Blade, indirect C/L video view improved to C/L class 1 in 15 patients, and to 2a in 5 patients, respectively. The time from touching the laryngoscope to optimal laryngoscopic view was 11 (5-45) seconds and for successful intubation 17 (3-80) seconds. In all 35 patients, with the D-Blade no direct view of the glottis was possible and subsequently a semiflexible tube guide was required.
在本初步研究中，我们评估了 C-MAC® D-Blade（Karl Storz，德国图特林根），一种用于困难插管的新型视频喉镜 C-MAC 叶片，用于常规和困难插管。首先，在 15 例气道正常的连续患者中，在常规麻醉诱导期间同时使用常规直接喉镜和 D-Blade。其次，当常规直接喉镜失败时，在 300 例连续患者中的 20 例中，将 D-Blade 用作抢救设备。在 15 例常规麻醉诱导期间，直接喉镜下，7 例和 8 例患者的 Cormack-Lehane（C/L）分级分别为 1 级和 2a 级。所有患者均能首次插入 D-Blade 并获得声门的视频视图；使用 D-Blade，所有 15 例患者的 C/L 均为 1 级。使用 D-Blade 成功插管的时间为 15（8-26）秒（中位数（范围））。在 20 例直接喉镜检查出现意外困难的患者中，15 例和 5 例患者的 C/L 分级分别为 3 级和 4 级。使用 D-Blade，间接 C/L 视频视图改善为 15 例患者的 C/L 1 级和 5 例患者的 2a 级。从触摸喉镜到最佳喉镜视野的时间为 11（5-45）秒，成功插管的时间为 17（3-80）秒。在所有 35 例患者中，使用 D-Blade 无法直接观察到声门，随后需要使用半刚性管引导器。
