Jafra Anudeep, Gombar Satinder, Kapoor Dheeraj, Sandhu Harpreet Singh, Kumari Kamlesh
Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Anesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India.
Saudi J Anaesth. 2018 Apr-Jun;12(2):272-278. doi: 10.4103/sja.SJA_543_17.
The aim of the study was to compare the ease the intubation using GlideScope video laryngoscope and Macintosh laryngoscope in adult patients undergoing elective surgery under general anesthesia.
A total of 200 American Society of Anesthesiologists I-II patients of either sex, in the age group of 18-60 years were included in the study. Patients were randomly allocated to two groups. We assessed ease of intubation depending on time to tracheal intubation, number of attempts, glottic view (Cormack-Lehane grade [CL grade] and percentage of glottis opening [POGO]) and intubation difficulty score (IDS), hemodynamic variables and any intra- and post-operative adverse events.
The rate of successful endotracheal intubation (ETI) in both groups was 100% in the first attempt. The time required for successful ETI was 24.89 ± 5.574 in Group G and 20.68 ± 3.637 in Group M ( < 0.001) found to be statistically significant. There was significant improvement in glottic view with GlideScope (as assessed by POGO score 66.71 ± 29.929 and 94.40 ± 10.476 in group G and 75.85 ± 26.969 and 74.20 ± 29.514 Group M and CL grading [ < 0.001]). A comparison of mean IDS between two groups revealed intubation was easier with the use of GlideScope. The hemodynamic response to intubation was significantly lesser with the use of GlideScope when compared with Macintosh laryngoscope. The incidence of adverse events, though minor like superficial lip or tongue bleed, was similar in two groups.
GlideScope offers superiority over Macintosh laryngoscope in terms of laryngeal views and the difficulty encountered at ETI in an unselected population.
本研究的目的是比较在全身麻醉下接受择期手术的成年患者中，使用GlideScope视频喉镜和麦金托什喉镜进行气管插管的难易程度。
本研究纳入了200例年龄在18至60岁之间、美国麻醉医师协会分级为I-II级的成年患者，性别不限。患者被随机分为两组。我们根据气管插管时间、尝试次数、声门视野（科马克-莱汉分级[CL分级]和声门开口百分比[POGO]）以及插管难度评分（IDS）、血流动力学变量以及任何术中及术后不良事件来评估插管的难易程度。
两组首次尝试气管插管成功（ETI）率均为100%。G组成功进行ETI所需时间为24.89±5.574秒，M组为20.68±3.637秒（P<0.001），差异具有统计学意义。使用GlideScope时声门视野有显著改善（通过POGO评分评估，G组为66.71±29.929和94.40±10.476，M组为75.85±26.969和74.20±29.514，以及CL分级[P<0.001]）。两组平均IDS比较显示，使用GlideScope插管更容易。与麦金托什喉镜相比，使用GlideScope时插管引起的血流动力学反应明显较小。不良事件发生率虽轻微，如唇部或舌部浅表出血，但两组相似。
在未选择的人群中，就喉镜视野和声门暴露困难程度而言，GlideScope比麦金托什喉镜更具优势。
