Durga Padmaja, Kaur Jasleen, Ahmed Syed Younus, Kaniti Geeta, Ramachandran Gopinath
Department of Anesthesiology, Nizam's Institute of Medical Sciences, Panjagutta, Hyderabad, Andhra Pradesh, India.
Indian J Anaesth. 2012 Nov;56(6):529-34. doi: 10.4103/0019-5049.104568.
It is difficult to visualise the larynx using conventional laryngoscopy in the presence of cervical spine immobilisation. Airtraq(®) provides for easy and successful intubation in the neutral neck position.
To evaluate the effectiveness of Airtraq in comparison with the Mc Coy laryngoscope, when performing tracheal intubation in patients with neck immobilisation using hard cervical collar and manual in-line axial cervical spine stabilisation.
A randomised, cross-over, open-labelled study was undertaken in 60 ASA I and II patients aged between 20 and 50 years, belonging to either gender, scheduled to undergo elective surgical procedures. Following induction and adequate muscle relaxation, they were intubated using either of the techniques first, followed by the other. Intubation time and Intubation Difficulty Score (IDS) were noted using Mc Coy laryngoscope and Airtraq. The anaesthesiologist was asked to grade the ease of intubation on a Visual Analogue Scale (VAS) of 1-10. Chi-square test was used for comparison of categorical data between the groups and paired sample t-test for comparison of continuous data. IDS score and VAS were compared using Wilcoxon Signed ranked test.
The mean intubation time was 33.27 sec (13.25) for laryngoscopy and 28.95 sec (18.53) for Airtraq (P=0.32). The median IDS values were 4 (interquartile range (IQR) 1-6) and 0 (IQR 0-1) for laryngoscopy and Airtraq, respectively (P=0.007). The median Cormack Lehane glottic view grade was 3 (IQR 2-4) and 1 (IQR 1-1) for laryngoscopy and Airtraq, respectively (P=0.003). The ease of intubation on VAS was graded as 4 (IQR 3-5) for laryngoscopy and 2 (IQR 2-2) for Airtraq (P=0.033). There were two failures to intubate with the Airtraq.
Airtraq improves the ease of intubation significantly when compared to Mc Coy blade in patients immobilised with cervical collar and manual in-line stabilisation simulating cervical spine injury.
在颈椎固定的情况下，使用传统喉镜难以看清喉部。Airtraq（®）喉镜能在颈部处于中立位时轻松、成功地进行气管插管。
在使用硬颈托固定颈部并手动进行轴向颈椎稳定的患者中，评估Airtraq喉镜与麦考伊喉镜相比在气管插管时的有效性。
对60例年龄在20至50岁之间、美国麻醉医师协会（ASA）分级为I级和II级、性别不限、计划接受择期外科手术的患者进行了一项随机、交叉、开放标签的研究。诱导麻醉并给予充分的肌肉松弛后，先使用其中一种技术进行插管，然后再使用另一种技术。使用麦考伊喉镜和Airtraq喉镜记录插管时间和插管难度评分（IDS）。要求麻醉医师在1至10的视觉模拟量表（VAS）上对插管的难易程度进行评分。采用卡方检验比较两组间的分类数据，采用配对样本t检验比较连续数据。使用Wilcoxon符号秩和检验比较IDS评分和VAS评分。
喉镜检查的平均插管时间为33.27秒（标准差13.25），Airtraq喉镜为28.95秒（标准差18.53）（P = 0.32）。喉镜检查和Airtraq喉镜的IDS中位数分别为4（四分位间距（IQR）1 - 6）和0（IQR 0 - 1）（P = 0.007）。喉镜检查和Airtraq喉镜的Cormack Lehane声门视图分级中位数分别为3（IQR 2 - 4）和1（IQR 1 - 1）（P = 0.003）。VAS上插管的难易程度评分，喉镜检查为4（IQR 3 - 5），Airtraq喉镜为2（IQR 2 - 2）（P = 0.033）。使用Airtraq喉镜时有两次插管失败。
在使用颈托固定颈部并手动进行轴向稳定模拟颈椎损伤的患者中，与麦考伊喉镜相比，Airtraq喉镜显著提高了插管的难易程度。
