Lee Jiyoung, Kwak Hyun Jeong, Lee Ji Yeon, Chang Min Young, Lee Sook Young, Kim Jong Yeop
aDepartment of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, Seongnam bDepartment of Anesthesiology and Pain Medicine, Gachon University, Gil Medical Center, Incheon cDepartment of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea.
Medicine (Baltimore). 2017 Nov;96(46):e8713. doi: 10.1097/MD.0000000000008713.
Various videolaryngoscopes (VLs) have been developed to provide a better laryngeal view and facilitate difficult intubations. The goal of this study was to compare 2 VLs, the Pentax AWS and the McGrath VL, with respect to intubation time and ease of intubation.One hundred forty patients aged 19 to 65 years (American Society of Anesthesiologists classification I or II), who required tracheal intubation for elective surgery, were randomly assigned to 1 of the 2 groups: the Pentax AWS (n = 70) or the McGrath VL (n = 70). The primary outcome was time to intubation (TTI) measured by a blind observer. The intubation difficulty scale (IDS), percentage of glottic opening (POGO) scale, glottic grade, use of optimal external laryngeal manipulation (OELM), and ease of intubation were also recorded.The Pentax AWS provided a better laryngeal view than the McGrath VL with respect to the Cormack-Lehane (CL) glottic grade (1/2a/2b) (63/7/0 vs 43/24/3, P < .001) and the POGO scale (median [interquartile range, IQR]) (100 [100-100] vs 100 [80-100], P < .001). The IDS was significantly lower in the Pentax AWS group compared with the McGrath VL group (median [IQR]) (0 [0-0] vs 0 [0-1], P < .001). However, the TTI was similar in both the Pentax AWS and McGrath VL groups (median [IQR]) (30 [27-34] vs 32 [27-35] seconds, P = .440). OELM and ease of intubation were also similar between the 2 groups.The Pentax AWS offered a superior laryngeal view compared with the McGrath VL. There was no significant difference in either the intubation time or ease of intubation using these 2 devices in patients with normal airways.
已研发出各种视频喉镜（VLs），以提供更好的喉部视野并便于困难气道插管。本研究的目的是比较两种视频喉镜，即宾得AWS喉镜和麦格拉斯视频喉镜在插管时间和插管难易程度方面的差异。140例年龄在19至65岁之间（美国麻醉医师协会分级为I或II级）、因择期手术需要气管插管的患者被随机分为两组中的一组：宾得AWS组（n = 70）或麦格拉斯视频喉镜组（n = 70）。主要结局指标是由一名盲法观察者测量的插管时间（TTI）。还记录了插管困难量表（IDS）、声门开口百分比（POGO）量表、声门分级、最佳外部喉操作（OELM）的使用情况以及插管的难易程度。在Cormack-Lehane（CL）声门分级（1/2a/2b）方面（63/7/0对43/24/3，P <.001）以及POGO量表（中位数[四分位间距，IQR]）方面（100 [100 - 100]对(100 [80 - 100])，P <.001），宾得AWS喉镜提供的喉部视野比麦格拉斯视频喉镜更好。与麦格拉斯视频喉镜组相比，宾得AWS喉镜组的IDS显著更低（中位数[IQR]）（0 [0 - 0]对0 [0 - 1]，P <.001）。然而，宾得AWS喉镜组和麦格拉斯视频喉镜组的TTI相似（中位数[IQR]）（30 [27 - 34]对32 [27 - 35]秒，P =.440）。两组之间的OELM和插管难易程度也相似。与麦格拉斯视频喉镜相比，宾得AWS喉镜提供了更优越的喉部视野。在气道正常的患者中，使用这两种设备的插管时间或插管难易程度均无显著差异。
