可视喉镜与 Airtraq DL 在预测或已知困难气道患者双腔气管导管插入中的比较：一项随机研究。

Glidescope versus Airtraq DL for double-lumen tracheal tube insertion in patients with a predicted or known difficult airway: A randomised study.

机构信息

From the Department of Anaesthesia, Hôpital Foch, Suresnes, France (OB, EL); and Department of Anaesthesia, Pôle Anesthésie Réanimation, Université François-Rabelais, CHRU de Tours, Tours Cedex 09, France (YB, PK, JF, FR, FE).

出版信息

Eur J Anaesthesiol. 2017 Jul;34(7):456-463. doi: 10.1097/EJA.0000000000000655.

DOI:10.1097/EJA.0000000000000655

PMID:28525401

Abstract

BACKGROUND

Double-lumen tracheal tube (DLT) insertion can be managed with videolaryngoscopes such as the Glidescope or indirect laryngoscopes like the Airtraq DL. No study has compared both devices when a difficult intubation is predicted.

OBJECTIVE

Our hypothesis was that the Glidescope is superior to the Airtraq for double-lumen tube insertion in patients with a predicted or known difficult airway.

DESIGN

Randomised study.

PATIENTS

Adults scheduled for thoracic elective surgery, requiring one-lung ventilation with a predicted difficult intubation score of at least 7 (Arné risk index).

INTERVENTION

Between March 2014 and March 2015, adult patients, scheduled for elective thoracic surgery, requiring double-lumen tracheal tube placement, and with a predicted risk (evaluated preoperatively using the Arné score) or a history of difficult intubation, were allocated to a Glidescope or an Airtraq group.

MAIN OUTCOME MEASURES

The primary outcome was the overall success rate of tracheal intubation after two attempts. Secondary outcomes were success rates on the first attempt, duration of intubation, need for laryngeal pressure, Cormack and Lehane grade and side-effects.

RESULTS

Of 277 patients, 78 were predicted to have a difficult airway. Finally, 72 patients were enrolled. Neither the overall success rates of tracheal intubation [Glidescope group 31/36 (86%) versus Airtraq group 34/36 (94%), P = 0.43] nor the side-effects differed between groups. There was no difference concerning visualisation of the glottis using the Cormack and Lehane grade (P = 0.18) or intubation time [Glidescope group 67 s (49 to 90) versus Airtraq group 81 s (59 to 101), P = 0.28]. All patients with a previous history of difficult intubation were intubated successfully.

CONCLUSION

There is no difference in success rates of tracheal intubation with a double-lumen tube in patients with a predicted or known difficult airway when using either a Glidescope or Airtraq device.

TRIAL REGISTRATION

National register of the French National Agency for Medicines and Health Products Safety No. 2014-A00143-44.

摘要

背景

双腔气管导管（DLT）的插入可以使用视频喉镜，如 Glidescope 或间接喉镜，如 Airtraq DL。当预测到困难插管时，还没有比较这两种设备的研究。

目的

我们的假设是，在预测有困难气道的患者中，Glidescope 优于 Airtraq 进行双腔管插入。

设计

随机研究。

患者

择期胸外科手术患者，预计插管困难评分至少为 7 分（Arné 风险指数）需要单肺通气。

干预

2014 年 3 月至 2015 年 3 月，择期胸外科手术患者，需要双腔气管导管置入，预计有插管困难风险（术前使用 Arné 评分评估）或有插管困难史，分为 Glidescope 组或 Airtraq 组。

主要观察指标

两次尝试后气管插管的总体成功率为主要观察指标。次要观察指标为首次尝试的成功率、插管时间、喉压需要、Cormack 和 Lehane 分级以及副作用。

结果

277 例患者中，78 例预计有困难气道。最终，72 例患者入组。气管插管的总体成功率[Glidescope 组 31/36（86%）与 Airtraq 组 34/36（94%），P=0.43]和副作用在两组之间无差异。使用 Cormack 和 Lehane 分级观察声门的效果（P=0.18）或插管时间[Glidescope 组 67s（49 至 90）与 Airtraq 组 81s（59 至 101），P=0.28]无差异。所有有困难插管史的患者均成功插管。