Tosh Pulak, Rajan Sunil, Kumar Lakshmi
Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India.
Anesth Essays Res. 2018 Jan-Mar;12(1):194-198. doi: 10.4103/aer.AER_121_17.
Although videolaryngoscopes improve glottic visualization, their actual usefulness in intubation is not yet established.
The primary objective was to compare the ease of oral intubation with the use of 60° angled styletted endotracheal tube versus that performed over bougie inserted under videolaryngoscopic guidance. The secondary objectives were assessment of incidence of airway loss, hemodynamic changes, and time and number of attempts at intubation.
This prospective randomized study was conducted in a tertiary care institution.
Seventy surgical patients requiring oral intubation were randomly allotted to Group S or Group B. Laryngoscopy was performed with Storz C-MAC videolaryngoscope using D-Blade. In Group S, patients were intubated with a 60° angled stylletted endotracheal tube. In Group B, a bougie was introduced into the trachea and endotracheal tube was railroaded over the bougie.
Chi-square test and independent sample -test were used as applicable.
The ease of intubation was significantly more in patients of Group S as compared to Group B (88.6% vs. 25.7%, respectively, < 0.001) with significantly shorter intubation time (16.97 ± 7.91 vs. 77.43 ± 35.55 s, respectively, < 0.001). The requirement of more than one attempt at intubation was significantly higher in Group B [57.1% vs. 5.7% < 0.001, respectively]. Group B showed a significantly high mean arterial pressure at 1 and 3 min following intubation with no significant change in heart rate.
Use of 60° angled styletted endotracheal tube resulted in easier and faster intubation as compared to intubation over a bougie when used with C-MAC videolaryngoscope.
尽管视频喉镜可改善声门可视化,但它们在插管中的实际效用尚未确定。
主要目的是比较使用60°角带管芯气管内导管进行经口插管与在视频喉镜引导下经探条插入气管内导管进行经口插管的难易程度。次要目的是评估气道丢失、血流动力学变化以及插管尝试的时间和次数。
这项前瞻性随机研究在一家三级医疗机构进行。
70例需要经口插管的外科患者被随机分配到S组或B组。使用D型叶片的Storz C-MAC视频喉镜进行喉镜检查。在S组,患者使用60°角带管芯气管内导管进行插管。在B组,将一根探条插入气管,然后将气管内导管沿探条推进。
适用时使用卡方检验和独立样本t检验。
与B组相比,S组患者的插管更容易(分别为88.6%和25.7%,P<0.001),插管时间显著更短(分别为16.97±7.91秒和77.43±35.55秒,P<0.001)。B组多次尝试插管的需求显著更高[分别为57.1%和5.7%,P<0.001]。B组在插管后1分钟和3分钟时平均动脉压显著升高,心率无显著变化。
与使用C-MAC视频喉镜时经探条插管相比,使用60°角带管芯气管内导管插管更容易、更快。