Anaesthesia and Critical Care Department 3, centre hospitalier universitaire de Bordeaux, place Amélie-Raba-Léon, Bordeaux 33076, France.
Anaesthesia and Critical Care Department 3, centre hospitalier universitaire de Bordeaux, place Amélie-Raba-Léon, Bordeaux 33076, France.
Anaesth Crit Care Pain Med. 2017 Oct;36(5):261-265. doi: 10.1016/j.accpm.2017.02.007. Epub 2017 Mar 18.
Airway management and tracheal intubation are routinely performed in paediatric anaesthesia and yet are associated with preventable adverse events. The McGrath MAC is a video laryngoscope with a curved blade similar to the Macintosh blade, which has not been previously described in first intention paediatric tracheal intubation. We aimed to compare direct laryngoscopy to the McGrath MAC video laryngoscope among novice laryngoscopists.
Six paediatric anaesthesia residents with novice skills in paediatric laryngoscopy were randomly assigned to perform tracheal intubation using either direct Macintosh laryngoscopy (DL) or the McGrath MAC video laryngoscope (MM) as the first attempted device in children weighing between 10 and 20kg without difficult intubation.
Our study enrolled 132 children between August 2013 and April 2015. The time to intubation was shorter in the DL group (n=67) compared to the MM group (n=65) with 42s (35-50) versus 48s (43-58) P=0.002. The time to best view was similar between the two groups (10s [7-16] versus 10s [8-15]; P=0.50). The tube passage time was shorter with DL (29s [25-35] versus 35s [30-45]; P=0.0002) and either Cormak & Lehane grade or Percentage Of Glottis Opening (POGO) scores were similar between groups. Minor reversible respiratory adverse events were similar between groups: 12 in the DL group (17.9%) versus 12 in the MM group (18.5%).
McGrath MAC video laryngoscopy, when performed by a novice laryngoscopist on easy-to-intubate children, is associated with longer intubation times.
气道管理和气管插管在小儿麻醉中经常进行，但与可预防的不良事件有关。麦格（McGrath）MAC 是一种视频喉镜，其叶片呈弯曲状，类似于 Macintosh 叶片，以前未在小儿气管插管的初次尝试中描述过。我们旨在比较初学者在小儿喉镜检查中使用直接喉镜和 McGrath MAC 视频喉镜。
6 名具有小儿喉镜检查新手技能的小儿麻醉住院医师随机分配，使用直接 Macintosh 喉镜（DL）或 McGrath MAC 视频喉镜（MM）作为 10-20kg 无困难插管的儿童的第一尝试设备进行气管插管。
我们的研究纳入了 2013 年 8 月至 2015 年 4 月期间的 132 名儿童。与 MM 组（n=65）相比，DL 组（n=67）的插管时间更短，为 42s（35-50）与 48s（43-58），P=0.002。两组之间最佳观察时间相似（10s [7-16] 与 10s [8-15]；P=0.50）。DL 的管腔通过时间更短（29s [25-35] 与 35s [30-45]；P=0.0002），Cormak & Lehane 分级或声门张开百分比（POGO）评分在两组之间相似。两组之间的轻微可逆性呼吸不良事件相似：DL 组 12 例（17.9%）与 MM 组 12 例（18.5%）。
当由初学者在易插管的儿童上进行时，麦格（McGrath）MAC 视频喉镜的插管时间较长。
