Bensghir Mustapha, Chouikh Chakib, Bouhabba Najib, Fjjouji Salaheddine, Kasouati Jalal, Azendour Hicham, Kamili Noredine Drissi
Pôle d'Anesthésie-Réanimation, Hôpital Militaire Med V, Rabat Agdal, Rabat, Maroc.
Can J Anaesth. 2013 Apr;60(4):377-84. doi: 10.1007/s12630-012-9870-x. Epub 2012 Dec 22.
To compare the performance of the Airtraq, X-Lite, and direct laryngoscopes for tracheal intubation for elective thyroid surgery.
In this randomized prospective study, Patients who were ASA (American Society of Anesthesiologists) I or II physical status I or II and patients undergoing thyroid surgery were included in this randomized prospective study. Patients with attributes for difficult intubation criteria were excluded. After induction of anesthesia with fentanyl, propofol, and cisatracurium, patients were randomized into three groups according to the intubating device used: Airtraq laryngoscope (Airtraq), X-Lite video laryngoscope (X-lLite), and direct laryngoscope with a Macintosh blade (Direct). The primary outcome measurement was the time needed for tracheal intubation. Secondary outcomes included intubation difficulty score (IDS), Cormack-Lehane classification, as well as hemodynamic and respiratory effects.
One hundred and five patients were included. Mean (standard deviation) time for intubation was 28.2 (2.1) sec in the Airtraq group vs 36.6 (3.7) sec in the X-Lite group (P < 0.001), and 41.1 (4.4) sec in the Direct group (P < 0.001). Compared with to the direct laryngoscope, the Airtraq provided better visualization of the glottis (P = 0.003) with fewer attempts (P < 0.001) and lower IDS (P < 0.001). The intubation difficulty score was lower with the Airtraq than with the X-Lite (P = 0.003). Patients in the X-Lite and Direct groups showed more hemodynamic variations than those in the Airtraq group. There was only one failed intubation, in the direct group.
In thyroid surgery, the Airtraq and X-Lite laryngoscopes decrease time to intubation when compared with direct laryngoscopy.
比较Airtraq喉镜、X-Lite喉镜和直接喉镜在择期甲状腺手术气管插管中的性能。
在这项随机前瞻性研究中，纳入美国麻醉医师协会（ASA）身体状况分级为I或II级且接受甲状腺手术的患者。排除具有困难插管标准特征的患者。在使用芬太尼、丙泊酚和顺式阿曲库铵诱导麻醉后，根据所使用的插管设备将患者随机分为三组：Airtraq喉镜组（Airtraq）、X-Lite视频喉镜组（X-Lite）和使用麦金托什叶片的直接喉镜组（Direct）。主要观察指标是气管插管所需时间。次要观察指标包括插管困难评分（IDS）、科马克-莱汉内分级，以及血流动力学和呼吸效应。
共纳入105例患者。Airtraq组的平均（标准差）插管时间为28.2（2.1）秒，X-Lite组为36.6（3.7）秒（P < 0.001），Direct组为41.1（4.4）秒（P < 0.001）。与直接喉镜相比，Airtraq喉镜对声门的视野更好（P = 0.003），尝试次数更少（P < 0.001），IDS更低（P < 0.001）。Airtraq喉镜的插管困难评分低于X-Lite喉镜（P = 0.003）。X-Lite组和Direct组患者的血流动力学变化比Airtraq组更多。直接喉镜组仅发生1例插管失败。
在甲状腺手术中，与直接喉镜相比，Airtraq喉镜和X-Lite喉镜可缩短插管时间。
