Hosalli Vinod, Arjun B K, Ambi Uday, Hulakund Shivanand
S Nijalingappa Medical College, Hanagal Shree Kumareshwar Hospital and Research Center, Bagalkot, Karnataka, India.
Indian J Anaesth. 2017 Apr;61(4):332-337. doi: 10.4103/ija.IJA_517_16.
The study aimed at comparing the performance of the novel optical Airtraq™ laryngoscope with the McCoy™ and conventional Macintosh laryngoscopes for ease of endotracheal intubation in patients with neck immobilisation using manual inline axial cervical spine stabilisation (MIAS) technique.
Ninety consenting American Society of Anaesthesiologist's physical status I-II patients, aged 18-60 years, scheduled for various surgeries requiring tracheal intubation were randomly assigned into three groups of thirty each to undergo intubation with Macintosh, Airtraq™, or McCoy™ laryngoscope with neck immobilisation by MIAS technique. The ease of intubation based on Intubation difficulty scale (IDS) score, Cormack-Lehane grade of glottic view, optimisation manoeuvres and impact on haemodynamic parameters were recorded. Statistical analysis was performed with ANOVA and Bonferroni correction for tests.
All patients in three groups had a comparable demographic profile and were successfully intubated. The Airtraq™ laryngoscope significantly reduced the IDS (mean - 0.43 ± 0.81) as compared with both McCoy™ (mean - 1.63 ± 1.49, = 0.001) and Macintosh laryngoscope (mean -2.23 ± 1.92, < 0.001) and improved the Cormack-Lehane glottic view (77% grade 1 view and no patients with grade 3 or 4 view). There were less haemodynamic variations during laryngoscopy with the Airtraq™ compared to the Macintosh laryngoscope, but there was not between the Airtraq™ and McCoy™ laryngoscope groups.
In patients undergoing endotracheal intubation with cervical immobilisation, Airtraq™ laryngoscope was superior to the McCoy™ and Macintosh laryngoscopes, with greater ease of intubation and lower impact on haemodynamic variables.
本研究旨在比较新型光学Airtraq™喉镜与McCoy™喉镜及传统Macintosh喉镜在采用手动轴向颈椎固定（MIAS）技术对颈部固定患者进行气管插管时的操作表现。
90例年龄在18 - 60岁、美国麻醉医师协会身体状况分级为I - II级、同意参与研究且计划进行各种需要气管插管手术的患者，被随机分为三组，每组30例，分别使用Macintosh喉镜、Airtraq™喉镜或McCoy™喉镜，采用MIAS技术固定颈部后进行插管。记录基于插管难度量表（IDS）评分的插管难易程度、声门视野的Cormack - Lehane分级、优化操作以及对血流动力学参数的影响。采用方差分析和Bonferroni校正进行统计学分析。
三组所有患者的人口统计学特征相似，均成功插管。与McCoy™喉镜（平均 - 1.63 ± 1.49，P = 0.001）和Macintosh喉镜（平均 - 2.23 ± 1.92，P < 0.001）相比，Airtraq™喉镜显著降低了IDS（平均 - 0.43 ± 0.81），并改善了Cormack - Lehane声门视野（77%为1级视野，无3级或4级视野患者）。与Macintosh喉镜相比，使用Airtraq™喉镜进行喉镜检查时血流动力学变化较小，但Airtraq™喉镜组与McCoy™喉镜组之间无差异。
在颈部固定的气管插管患者中，Airtraq™喉镜优于McCoy™喉镜和Macintosh喉镜，插管更容易，对血流动力学变量的影响更小。
