Arora Suman, Sayeed Huma, Bhardwaj Neerja
Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Saudi J Anaesth. 2013 Jul;7(3):244-8. doi: 10.4103/1658-354X.115322.
The Truview EVO2 blade facilitates the view of vocal cords by indirect laryngoscopy and does not require the proper alignment of the oral, pharyngeal and tracheal axes as with the Macintosh blade.
In a crossover fashion, we prospectively compared the view obtained at laryngoscopy with Truview EVO2 and the Macintosh blade in 110 adult patients of either sex between the age of 18 and 60 years, who were scheduled to undergo general anesthesia with endotracheal intubation. The patients were intubated with the second laryngoscope. The preoperative airway variables, laryngoscopic view, difficulty of intubation scale (IDS) score, duration of intubation, and degree of difficulty percentage of glottic opening (POGO score) of use with each laryngoscope were compared.
The IDS score was low and comparable between the two laryngoscopes. The laryngeal view was easy; Modified Cormack Lehane (MCL) grade 2a or less in 98.14% of the cases with the Truview laryngoscope compared to 78.7% of the cases with the Macintosh laryngoscope. Nineteen patients of MCL grade 3, one patient of grade 2b, and seven patients of grade 2a view with the Macintosh laryngoscope had MCL grade 1 view with the Truview laryngoscope. The duration of intubation was comparable between Truview and Macintosh laryngoscopes (12.1±3.8 s vs. 10.9±2.1 s).
Truview laryngoscope performed comparably to Macintosh laryngoscope in patients with normal airway; however, the Truview laryngoscope may be a better option in difficult airway situations when the Macintosh blade fails to show the glottic opening.
Truview EVO2喉镜可通过间接喉镜检查辅助观察声带,且不像麦金托什喉镜那样需要口腔、咽和气管轴的正确对齐。
我们采用交叉方式,对110例年龄在18至60岁之间、计划接受全身麻醉并气管插管的成年男女患者,前瞻性地比较了使用Truview EVO2喉镜和麦金托什喉镜进行喉镜检查时获得的视野。患者使用第二种喉镜进行插管。比较了术前气道变量、喉镜视野、插管困难量表(IDS)评分、插管持续时间以及每种喉镜使用时声门开口困难程度百分比(POGO评分)。
两种喉镜的IDS评分均较低且相当。喉镜视野容易;使用Truview喉镜时,98.14%的病例改良科马克-莱汉内(MCL)分级为2a级或更低,而使用麦金托什喉镜时为78.7%。使用麦金托什喉镜时MCL分级为3级的19例患者、2b级的1例患者和2a级视野的7例患者,使用Truview喉镜时MCL分级为1级。Truview喉镜和麦金托什喉镜的插管持续时间相当(12.1±3.8秒对10.9±2.1秒)。
在气道正常的患者中,Truview喉镜的表现与麦金托什喉镜相当;然而,当麦金托什喉镜无法显示声门开口时,在困难气道情况下,Truview喉镜可能是更好的选择。