*Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang Chinese Medical University †Department of Anesthesiology, The Children's Hospital ‡Department of Anesthesiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
J Neurosurg Anesthesiol. 2014 Jan;26(1):27-31. doi: 10.1097/ANA.0b013e31829a0491.
The GlideScope (GS) video laryngoscope has been proven to be a suitable intubating device for a predicted difficult intubation. Patients with ankylosing spondylitis (AS) presented with particularly challenging airway management problems to the anesthesiologists. The benefits of using a GS in these patients have not been fully explored. The aim of this study was to evaluate the effectiveness of the GS, in comparison with the Macintosh laryngoscope, when performing nasotracheal intubation in patients with AS under general anesthesia.
A total of 60 ASA I-II patients with AS were randomly assigned to undergo nasotracheal intubation using either the GS or the Macintosh laryngoscope. Preoperative airway assessments were performed in an attempt to predict the difficulty of tracheal intubation. Duration and number of intubation attempts, success rates, number of optimization maneuvers, Cormack and Lehane grades, Percentage of Glottic Opening (POGO) scores for each attempt, and difficulty of device use (VAS difficulty scores) were recorded. Complications associated with intubation were also recorded.
The rate of successful nasotracheal intubation was lower with the Macintosh laryngoscope (70%) compared with the GS (96.7%). In comparison with the Macintosh laryngoscope, the GS significantly reduced the intubation difficulty score, duration of tracheal intubation attempts, need for optimization maneuvers, and improved the Cormack and Lehane grade obtained during laryngoscopy.
The GS reduced the difficulty of tracheal intubation and provided a better laryngoscopic view with higher overall success rates and shorter duration of intubation attempts than the Macintosh laryngoscope. In our study, the GS proved to be a better alternative in most cases, compared with the Macintosh laryngoscope, for intubating AS patients who preferred their airway management under general anesthesia.
GlideScope（GS）视频喉镜已被证明是一种适用于预测困难插管的插管设备。患有强直性脊柱炎（AS）的患者给麻醉师带来了特别具有挑战性的气道管理问题。使用 GS 的好处尚未得到充分探索。本研究旨在评估 GS 在全身麻醉下进行经鼻气管插管时与 Macintosh 喉镜相比的有效性，适用于 AS 患者。
共有 60 名 ASA I-II 级 AS 患者随机分为 GS 或 Macintosh 喉镜组进行经鼻气管插管。进行术前气道评估，以尝试预测气管插管的难度。记录插管时间和尝试次数、成功率、优化操作次数、Cormack 和 Lehane 分级、每次尝试的声门开放百分比（POGO）评分以及设备使用难度（VAS 难度评分）。还记录了与插管相关的并发症。
Macintosh 喉镜组（70%）的经鼻气管插管成功率低于 GS 组（96.7%）。与 Macintosh 喉镜相比，GS 显著降低了插管难度评分、气管插管尝试时间、优化操作的需要，并改善了喉镜检查时获得的 Cormack 和 Lehane 分级。
与 Macintosh 喉镜相比，GS 降低了气管插管的难度，并提供了更好的喉镜视野，总体成功率更高，插管尝试时间更短。在我们的研究中，与 Macintosh 喉镜相比，GS 被证明是大多数情况下为首选全身麻醉下气道管理的 AS 患者进行插管的更好选择。
