使用King Vision™视频喉镜直视下插入胃管：一项随机、前瞻性临床试验。

Gastric tube insertion under direct vision using the King Vision™ video laryngoscope: a randomized, prospective, clinical trial.

作者信息

Okabe Tadashi, Goto Gentaro, Hori Yoko, Sakamoto Atsuhiro

机构信息

Department of Anesthesiology, Hitachi, Ltd. Hitachinaka General Hospital, 20-1 Ishikawa-cho, Hitachinaka-shi, Ibaraki 312-0057, Japan.

Department of Anesthesiology, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo 113-8603, Japan.

出版信息

BMC Anesthesiol. 2014 Sep 25;14:82. doi: 10.1186/1471-2253-14-82. eCollection 2014.

DOI:10.1186/1471-2253-14-82

PMID:25278810

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4180947/

Abstract

BACKGROUND

The frequency of malpositioning of gastric tubes in the trachea has been reported to be 0.3-15%, which may cause severe complications, such as pneumonia, if not detected promptly. If a gastric tube can be guided into the esophagus under direct vision with a video laryngoscope, misplacement of the gastric tube into the trachea can be avoided. We compared gastric tube insertion under direct vision using a video laryngoscope with the conventional method of blind insertion.

METHODS

We enrolled 60 patients who required a transnasal gastric tube to facilitate elective abdominal surgery under general anesthesia. The participants were recruited consecutively into one of two groups, a group of 30 patients in whom a gastric tube was inserted using a King Vision™ video laryngoscope (KV group), and a group of 30 patients who underwent conventional blind insertion of the gastric tube (Blind group). The success rate, the time taken to insert the gastric tube, and the incidence of complications were compared.

RESULTS

In the KV group, the time required for gastric tube placement was 52.5 ± 17.1 seconds, with a success rate of 100%. Slight oral hemorrhage occurred in two participants and slight epistaxis in one participant. In the Blind group, the time required for gastric tube placement was 65.9 ± 39.9 seconds, with a success rate of 90% (27 out of 30 patients). Slight oral hemorrhage occurred in two participants, slight epistaxis occurred in two participants, and tracheal malposition occurred in one participant but was detected promptly and corrected using the video laryngoscope. There were no significant differences in the time required for placing the gastric tube, the success rate, or the incidence of complications between the groups.

CONCLUSIONS

Gastric tube insertion using a King Vision video laryngoscope was straightforward, and was particularly useful for detecting and correcting tracheal malpositioning.

TRIAL REGISTRY NUMBER

UMIN000011014.

摘要

背景

据报道，胃管误入气管的发生率为0.3% - 15%，若未及时发现，可能会导致严重并发症，如肺炎。如果能通过视频喉镜在直视下将胃管导入食管，就可以避免胃管误入气管。我们比较了使用视频喉镜直视下插入胃管与传统盲插法。

方法

我们纳入了60例在全身麻醉下需要经鼻插入胃管以方便择期腹部手术的患者。参与者被连续纳入两组之一，一组30例患者使用King Vision™视频喉镜插入胃管（KV组），另一组30例患者接受传统的胃管盲插（盲插组）。比较成功率、插入胃管所需时间和并发症发生率。

结果

在KV组，放置胃管所需时间为52.5±17.1秒，成功率为100%。两名参与者出现轻微口腔出血，一名参与者出现轻微鼻出血。在盲插组，放置胃管所需时间为65.9±39.9秒，成功率为90%（30例患者中的27例）。两名参与者出现轻微口腔出血，两名参与者出现轻微鼻出血，一名参与者出现气管误置，但通过视频喉镜及时发现并纠正。两组之间在放置胃管所需时间、成功率或并发症发生率方面没有显著差异。