Pavani Karri, Krishna Handattu Mahabaleswara, Nandhini Joseph
Department of Anesthesiology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
J Anaesthesiol Clin Pharmacol. 2017 Oct-Dec;33(4):473-479. doi: 10.4103/0970-9185.222507.
Higher success rate of intubation is observed with the reverse orientation of polyvinyl chloride (PVC) tracheal tube while intubating through laryngeal mask airway (LMA) Fastrach™. It is not clear whether the same is true during intubation through LMA CTrach™ visualizing the process of intubation. The primary aim of this study was to compare the influence of the PVC tracheal tube orientation on the success rate of intubation while intubating through LMA CTrach™.
One-hundred and fifty patients belonging to American Society of Anesthesiologists status I-II, undergoing elective surgery under general anesthesia were randomized to either group normal orientation or group reverse orientation. A maximum of 3 intubation attempts within a span of 3 min was allowed in each group before the change over to the other group. If intubation failed with the other orientation of the tube also, then intubation through LMA CTrach™ was abandoned and intubation done by direct laryngoscopy. The success of intubation, time, maneuvers, postoperative sore throat, and hoarseness were recorded.
Tracheal intubation through LMA CTrach™ with PVC tube was successful in 94.5% of patients in group normal orientation and in 98.6% of patients in group reverse orientation. The first attempt success rate was 75.3% and 86.3% in group normal and group reverse orientation, respectively. The incidence of a sore throat was higher in the group normal orientation than in the reverse orientation (31.8% and 26.5%, respectively).
Overall success rate of intubation was comparable between the two groups. Though statistically insignificant, the first attempt success rate was higher in group reverse orientation.
在通过喉罩气道(LMA)Fastrach™进行插管时,观察到聚氯乙烯(PVC)气管导管反向放置时插管成功率更高。在通过LMA CTrach™可视化插管过程进行插管时情况是否相同尚不清楚。本研究的主要目的是比较PVC气管导管放置方向对通过LMA CTrach™进行插管时插管成功率的影响。
150例美国麻醉医师协会分级为I-II级、在全身麻醉下接受择期手术的患者被随机分为正常放置组或反向放置组。每组在3分钟内最多允许进行3次插管尝试,之后更换为另一组。如果使用导管的另一种放置方向插管也失败,则放弃通过LMA CTrach™进行插管,改为直接喉镜插管。记录插管成功率、时间、操作、术后咽痛和声音嘶哑情况。
正常放置组94.5%的患者通过LMA CTrach™使用PVC导管成功插管,反向放置组为98.6%。正常放置组和反向放置组的首次尝试成功率分别为75.3%和86.3%。正常放置组咽痛发生率高于反向放置组(分别为31.8%和26.5%)。
两组插管总体成功率相当。虽然无统计学意义,但反向放置组首次尝试成功率更高。