Gaszynski Tomasz, Pietrzyk Monika, Szewczyk Tomasz, Gaszynska Ewelina
Department of Emergency Medicine and Disaster Medicine, Medical University of Lodz, 90 - 131 Lodz, Poland.
Department of Anesthesiology and Intensive Therapy, Barlicki University Hospital, Medical University of Lodz, Ulice Kopcinskiego 22, 90 - 153 Lodz, Poland.
ScientificWorldJournal. 2014;2014:207591. doi: 10.1155/2014/207591. Epub 2014 May 20.
The use of videolaryngoscopes is recommended for morbidly obese patients. The aim of the study was to evaluate the Levitan FPS optical stylet (Levitan) vs Lafy-Flex videolaryngoscope (Lary-Flex) in a group of MO patients.
Seventy-nine MO (BMI > 40 kg m(-2)) patients scheduled for bariatric surgery were included in the study and randomly allocated to the Levitan FPS or Lary-Flex group. The primary endpoint was time to intubation and evaluation laryngoscopic of glottic view. Anesthesiologists were asked to evaluate the glottic view first under direct laryngoscopy using the videolaryngoscope as a standard laryngoscope (monitor display was excluded from use) and then using devices. The secondary endpoint was the cardiovascular response to intubation and the participant's evaluation of such devices.
The time to intubation was 8.572.66 sec. versus 5.790.2 sec. for Levitan and Lary-Flex, respectively (P < 0.05). In all cases of CL grade >1 under direct laryngoscopy, the study devices improved CL grade to 1. The Levitan FPS produced a greater cardiovascular response than the Lary-Flex videolaryngoscope.
The Lary-Flex videolaryngoscope and the Levitan FPS optical stylet improve the laryngeal visualization in morbidly obese patients, allowing for fast endotracheal intubation, but Lary-Flex produces less cardiovascular response to intubation attempt.
建议对病态肥胖患者使用视频喉镜。本研究的目的是在一组病态肥胖患者中评估Levitan FPS光学探条(Levitan)与Lafy-Flex视频喉镜(Lary-Flex)。
79例计划接受减肥手术的病态肥胖(BMI>40 kg/m²)患者纳入研究,并随机分配至Levitan FPS组或Lary-Flex组。主要终点是插管时间和声门视野的喉镜评估。要求麻醉医生首先在直接喉镜检查下,将视频喉镜用作标准喉镜(不使用监视器显示屏)评估声门视野,然后使用设备评估。次要终点是插管时的心血管反应以及参与者对这些设备的评价。
Levitan组和Lary-Flex组的插管时间分别为8.57±2.66秒和5.79±0.2秒(P<0.05)。在直接喉镜检查下所有CL分级>1的病例中,研究设备将CL分级改善至1级。Levitan FPS比Lary-Flex视频喉镜产生更大的心血管反应。
Lary-Flex视频喉镜和Levitan FPS光学探条可改善病态肥胖患者的喉部视野,实现快速气管插管,但Lary-Flex在插管尝试时产生的心血管反应较小。