Casé León C K, Hachoue Saliba Z S
Servicio de Anestesiología, Instituto Venezolano Seguro Social, Hospital Dr. Montezuma Ginnari, Valera, Venezuela.
Rev Esp Anestesiol Reanim. 2013 Feb;60(2):74-8. doi: 10.1016/j.redar.2012.09.014. Epub 2012 Nov 15.
To evaluate the difficulty of intubation with a lighted stylet by correlating the body mass index (BMI) with the neck or cervical circumference (CC), and to establish the values of BMI and CC that could help identify a possible difficult intubation with this device.
An observational and correlational study was performed on selected patients by consecutive sampling who were intubated using the lighted stylet. Variables such as age, gender, ASA physical status, BMI, CC, transillumination intensity, Cormack-Lehane grade, and Mallampati scores, were recorded. Multivariable analyses were performed.
103 patients were included. The mean age of the patients was 39.0 ± 16.6 years, BMI 28.6 ± 6.8 kg/m² (33% obese and 29,1% overweight), CC 37.8 ± 4.6 cm. Those patients who presented difficulty for intubation had a CC 39.9 ± 5.2 cm (P ≤ 0.05), and a BMI 33.8 ± 7.6 kg/m² (P = 0.01).
A lineal correlation exists between a BMI above 33 kg/m² and/or a CC greater than 40 cm and a difficult intubation using lighted stylet. Another method other than transillumination is recommended for orotracheal intubation in a patient with both characteristics.
通过将体重指数（BMI）与颈部或颈围（CC）相关联，评估光棒引导插管的难度，并确定有助于识别使用该设备可能出现困难插管的BMI和CC值。
对使用光棒引导插管的选定患者进行连续抽样观察性和相关性研究。记录年龄、性别、美国麻醉医师协会（ASA）身体状况、BMI、CC、透照强度、Cormack-Lehane分级和Mallampati评分等变量。进行多变量分析。
纳入103例患者。患者平均年龄为39.0±16.6岁，BMI为28.6±6.8kg/m²（33%为肥胖，29.1%为超重），CC为37.8±4.6cm。插管困难的患者CC为39.9±5.2cm（P≤0.05），BMI为33.8±7.6kg/m²（P=0.01）。
BMI高于33kg/m²和/或CC大于40cm与使用光棒引导插管困难之间存在线性相关性。对于同时具有这两种特征的患者，建议采用除透照以外的其他方法进行口气管插管。
