Tabrizi Reza, Dahi Mastaneh, Moshari Mohammad Reza, Pourdanesh Fereydoon, Zolfigol Sahar
Associate Professor of Oral and Maxillofacial Surgery, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Associate Professor of Anesthesiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Oral Maxillofac Surg. 2018 Sep;76(9):1864-1868. doi: 10.1016/j.joms.2018.03.025. Epub 2018 Mar 28.
Successful intubation is challenging in patients with bilateral mandibular fractures. The aim of this study was to compare the video laryngoscope (VL) with the Macintosh laryngoscope (ML) for intubation of patients with bilateral mandibular fractures.
In this randomized controlled trial study, patients who had bilateral mandibular fractures (angle or subcondylar) were studied. Patients were randomly assigned to 1 of 2 groups using computerized randomization. Laryngoscopy was performed by the ML in group 1 and the VL in group 2. Intubation device (ML or VL) was the predictive factor of the study and age, maximum mouth opening (MMO), incisor fracture, and gender were the variables. Intubation time and successful intubation at the first attempt were the study outcomes. Independent t test was applied to compare intubation time, MMO, and age between the 2 groups.
Seventy-eight patients were studied (40 in group 1 and 38 in group 2). Mean intubation time was 33.02 ± 9.68 seconds in group 1 and 39.16 ± 7.40 seconds in group 2. Comparison of the data showed a significant difference between the 2 groups (P = .002). Twenty-four patients in group 1 and 31 in group 2 were successfully intubated at the first attempt. There was a significant difference in the number of successful or failed intubation attempts between the 2 groups (P = .03).
According to the present findings, use of the VL increased the first-attempt success rate of intubation in patients with bilateral mandibular fractures. Time of intubation could be longer when using the VL than when using the ML.
双侧下颌骨骨折患者的成功插管具有挑战性。本研究的目的是比较视频喉镜（VL）与麦金托什喉镜（ML）在双侧下颌骨骨折患者插管中的应用。
在这项随机对照试验研究中，对患有双侧下颌骨骨折（角部或髁突下）的患者进行了研究。使用计算机随机化将患者随机分配到2组中的1组。第1组使用ML进行喉镜检查，第2组使用VL。插管设备（ML或VL）是研究的预测因素，年龄、最大张口度（MMO）、门牙骨折和性别是变量。插管时间和首次尝试成功插管是研究结果。应用独立t检验比较两组之间的插管时间、MMO和年龄。
共研究了78例患者（第1组40例，第2组38例）。第1组的平均插管时间为33.02±9.68秒，第2组为39.16±7.40秒。数据比较显示两组之间存在显著差异（P = 0.002）。第1组24例患者和第2组31例患者首次尝试成功插管。两组之间成功或失败插管尝试的次数存在显著差异（P = 0.03）。
根据目前的研究结果，使用VL可提高双侧下颌骨骨折患者插管的首次成功率。使用VL时的插管时间可能比使用ML时更长。
