Bhat Ravi, Sanickop Channabasavaraj S, Patil Manjunath C, Umrani Vijay S, Dhorigol Mallikarjun G
Department of Anaesthesia, JN Medical College, KLE University, Belgaum, Karnataka, India.
J Anaesthesiol Clin Pharmacol. 2015 Apr-Jun;31(2):226-9. doi: 10.4103/0970-9185.155221.
Endotracheal intubation is conventionally performed when the patient is in supine position. It may be required to secure airway in laterally positioned patient. Tracheal intubation in lateral position seems to be difficult because the laryngeal view is compromised. Hence, C-MAC video laryngoscope (Karl Storz, Germany), a newer device using a modified macintosh blade may be useful for intubation in lateral position.
A total of 100 American Society of Anesthesiologists Grade I and II patients, randomly allotted to C-MAC or direct laryngoscopy group. Patients with difficult airway were excluded. After induction of anesthesia, patient was put in right-lateral position and intubation was carried out by consultant who is well-versed in using C-MAC laryngoscope. Time for intubation, number of attempts, Modified Cormack - Lehane grade, mucosal injury, and external laryngeal manipulation applied were noted.
Demographics and baseline airway assessments were analyzed using summary statistics. Unpaired t-test was used to assess intubation time. Number of attempts, esophageal intubation, dental injury, mucosal injury, use of stylet, and application of external laryngeal manipulation were analyzed using Chi-square test.
Overall intubation success rate was 100%. The time taken in C-MAC group was 24.8 ± 8.5 s and in direct group was 33.8 ± 9.12 s. The number of intubation attempts was not significant. Cormack - Lehane grade was better with C-MAC laryngoscope. Mucosal injury and use of external laryngeal manipulation was more in direct group.
C-MAC is better than Macintosh laryngoscope for intubation in lateral position.
传统上气管插管是在患者仰卧位时进行的。对于侧卧位的患者，可能也需要确保气道安全。侧卧位气管插管似乎很困难，因为喉镜视野受限。因此，C-MAC视频喉镜（德国卡尔史托斯公司），一种使用改良麦金托什叶片的新型设备，可能有助于侧卧位插管。
总共100例美国麻醉医师协会I级和II级患者，随机分配到C-MAC组或直接喉镜检查组。排除气道困难的患者。麻醉诱导后，将患者置于右侧卧位，由精通使用C-MAC喉镜的顾问进行插管。记录插管时间、尝试次数、改良Cormack-Lehane分级、黏膜损伤以及应用的外部喉部操作。
使用汇总统计分析人口统计学和基线气道评估。使用未配对t检验评估插管时间。使用卡方检验分析尝试次数、食管插管、牙齿损伤、黏膜损伤、探条使用以及外部喉部操作应用情况。
总体插管成功率为100%。C-MAC组的插管时间为24.8±8.5秒，直接喉镜检查组为33.8±9.12秒。插管尝试次数无显著差异。C-MAC喉镜的Cormack-Lehane分级更好。直接喉镜检查组的黏膜损伤和外部喉部操作应用更多。
在侧卧位插管方面，C-MAC比麦金托什喉镜更好。
