预测气道正常患者使用Airtraq喉镜和GlideScope进行双腔气管导管插管的比较：一项前瞻性随机试验。
Comparison of the Airtraq laryngoscope and the GlideScope for double-lumen tube intubation in patients with predicted normal airways: a prospective randomized trial.
作者信息
Yi Jie, Gong Yahong, Quan Xiang, Huang Yuguang
机构信息
Department of Anesthesiology, Chinese Academy of Medical Science, Peking Union Medical College Hospital, No.1 Shuaifuyuan Wangfujing Street, Beijing, 100730, P.R of China.
出版信息
BMC Anesthesiol. 2015 Apr 28;15:58. doi: 10.1186/s12871-015-0037-5.
BACKGROUND
The Airtraq laryngoscope and the GlideScope are commonly used in many airway scenarios. However, their features have not been fully described for double-lumen tube intubation. A prospective randomized study was designed to compare their intubation performances in thoracic surgery patients.
METHODS
Seventy ASA physical status I and II patients with predicted normal airway were scheduled for thoracic surgeries with double-lumen tube intubation. They were randomly assigned to one of two groups and intubated with either the Airtraq laryngoscope (group A, n = 35) or the GlideScope (group G, n = 35). Airway assessments were performed prior to anesthesia, and all patients were induced with a standard anesthetic regimen. The Cormack-Lehane grades were initially evaluated with a Macintosh laryngoscope and subsequently with the group-specific laryngoscope before intubation. Intubation time was recorded as the primary outcome. The Cormack-Lehane grade, the success of the first intubation attempt, the intubation difficulty scales and ease of tube advancement were noted. Hemodynamic variables during intubation and incidence of post-operative sore throat were documented as well.
RESULTS
The intubation time of group A was shorter than that of group G (36.6 ± 20.2 s vs. 54.6 ± 25.7 s, p = 0.002). The Cormack-Lehane grade (I/II/III/IV) was significantly better in group A (33/2/0/0 vs. 28/7/0/0, p = 0.042). The mean arterial pressure and heart rate rose to higher levels during intubation with the GlideScope than with the Airtraq laryngoscope. The success of the first intubation attempt and the intubation difficulty scales were comparable between the two groups. The numbers of patients who experienced postoperative sore throat were similar (6 vs. 8) in the two groups.
CONCLUSIONS
Compared with the GlideScope, the specially designed Airtraq laryngoscope might be more suitable for double-lumen tube intubations in patients with predicted normal airway.
TRIAL REGISTRATION
www.chictr.org Identifier: ChiCTR-TRC-11001628.
背景
Airtraq喉镜和GlideScope喉镜在许多气道管理场景中都常用。然而，它们在双腔气管导管插管方面的特点尚未得到充分描述。本前瞻性随机研究旨在比较它们在胸外科手术患者中的插管性能。
方法
70例气道预计正常的美国麻醉医师协会（ASA）身体状况I级和II级患者计划接受双腔气管导管插管的胸外科手术。他们被随机分为两组，分别使用Airtraq喉镜（A组，n = 35）或GlideScope喉镜（G组，n = 35）进行插管。在麻醉前进行气道评估，所有患者均采用标准麻醉方案诱导麻醉。在插管前，先用Macintosh喉镜初步评估Cormack-Lehane分级，随后用特定组别的喉镜进行评估。记录插管时间作为主要结局指标。记录Cormack-Lehane分级、首次插管尝试的成功率、插管困难量表以及导管推进的难易程度。还记录了插管期间的血流动力学变量和术后咽痛的发生率。
结果
A组的插管时间短于G组（36.6±20.2秒 vs. 54.6±25.7秒，p = 0.002）。A组的Cormack-Lehane分级（I/II/III/IV）明显更好（33/2/0/0 vs. 28/7/0/0，p = 0.042）。与使用Airtraq喉镜相比，使用GlideScope喉镜插管期间平均动脉压和心率升高到更高水平。两组之间首次插管尝试的成功率和插管困难量表相当。两组术后咽痛的患者数量相似（6例 vs. 8例）。
结论
与GlideScope喉镜相比，专门设计的Airtraq喉镜可能更适合气道预计正常的患者进行双腔气管导管插管。
试验注册
www.chictr.org 标识符：ChiCTR-TRC-11001628
Zotero 插件