Ertürk Tuna, Deniz Süleyman, Şimşek Fatih, Purtuloğlu Tarık, Kurt Ercan
Department of Anaesthesiology and Reanimation, Gülhane Military Medical Academy, Ankara, Turkey.
Department of Anaesthesiology and Reanimation, Gülhane Military Medical Academy Haydarpaşa Training Hospital, İstanbul, Turkey.
Turk J Anaesthesiol Reanim. 2015 Jun;43(3):181-7. doi: 10.5152/TJAR.2015.38278. Epub 2015 Feb 16.
Endotracheal intubation of patients is an effective method for controlling airway and breathing. However, laryngoscopy and endotracheal intubation is not easy in every case. There is a recent abundance of equipment used for controlling ventilation and intubation. Airtraq is one of those equipments. In this study, our main objective is to compare the success rates of the Airtraq and Macintosh (direct and classic) laryngoscopes in endotracheal intubation.
In this single-center, prospective, randomized, clinical study was performed on 80 patients who were operated under general anesthesia, ASA I-II, 18-65 years old. Patients were intubated using two different endotracheal intubation tools. Group A was intubated using the Macintosh (direct and classic) laryngoscope, meanwhile Group B was intubated using the Airtraq laryngoscope. Patients' snoring complaints, modified Mallampati scores, sternomental distances, thyromental distances, interincisor distance measurements and Cormack-Lehane (C-L) laryngoscopic classification, upper lip bite test results, intubation time, number of intubation attempts, maneuvers and techniques used for facilitating intubation and complications arising from intubation were recorded.
There was a statistically significant difference between the groups in terms of C-L scores (p=0.041). In all, 8 patients in the Macintosh group, and 2 patients in the Airtraq group were C-L grade III. In intubation of the Airtraq group, only 3 patients required facilitating techniques, meanwhile in intubation of the Macintosh group 15 patients we had to use one or more facilitating maneuver. The rate of Mallampati scoring "difficult" was 4/6 in the Macintosh and 2/11 in Airtraq laryngoscopy groups (p=0.553).
In cases with seemingly difficult intubations, we believe the Airtraq laryngoscope has an advantage over the Macintosh laryngoscope, owing to its better view of the oropharyngeal and glottic areas in addition to facilitating intubation in patients with limited head extension.
对患者进行气管插管是控制气道和呼吸的有效方法。然而，喉镜检查和气管插管并非在每种情况下都容易操作。最近有大量用于控制通气和插管的设备。Airtraq喉镜就是其中之一。在本研究中，我们的主要目的是比较Airtraq喉镜和Macintosh（直接和经典）喉镜在气管插管中的成功率。
在这项单中心、前瞻性、随机临床研究中，对80例年龄在18 - 65岁、美国麻醉医师协会（ASA）分级为I - II级、接受全身麻醉手术的患者进行了研究。使用两种不同的气管插管工具对患者进行插管。A组使用Macintosh（直接和经典）喉镜进行插管，同时B组使用Airtraq喉镜进行插管。记录患者的打鼾主诉、改良Mallampati评分、胸骨颏距离、甲状软骨颏距离、门齿间距离测量以及Cormack - Lehane（C - L）喉镜分级、上唇咬试验结果、插管时间、插管尝试次数、用于辅助插管的操作和技术以及插管引起的并发症。
两组在C - L评分方面存在统计学显著差异（p = 0.041）。Macintosh组共有8例患者，Airtraq组有2例患者为C - L III级。在Airtraq组插管时，只有3例患者需要辅助技术，而在Macintosh组插管时，有15例患者我们不得不使用一种或多种辅助操作。Macintosh喉镜检查组Mallampati评分“困难”的比例为4/6，Airtraq喉镜检查组为2/11（p = 0.553）。
在看似插管困难的病例中，我们认为Airtraq喉镜比Macintosh喉镜具有优势，这是因为它除了能更好地观察口咽和声门区域外，还能便于头部伸展受限的患者进行插管。
