Moustafa Moustafa Abdelaziz, Kandeel Alaa Abdelrahman, Habib Ahmed M A, Hassan Shady A
Department of Anaesthesia and Surgical Intensive Care, Alexandria Faculty of Medicine, Alexandria, Egypt.
Department of Maxillofacial and Plastic Surgery, Alexandria Faculty of Medicine, Alexandria, Egypt.
Indian J Anaesth. 2018 May;62(5):376-380. doi: 10.4103/ija.IJA_714_17.
The palatal defect and abnormal dentition in cleft palate make mask ventilation and laryngoscopy difficult. This study aimed to assess the effect of feeding obturator on laryngeal view in unilateral complete cleft palate.
Ninety non-syndromic infants scheduled for the first stage correction of complete unilateral cleft palate were randomised to Group A (no feeding obturator) or Group B (obturator used for induction and intubation). The primary objective was to assess effect of the feeding obturator on the Cormack-Lehane grade on laryngoscopy. Effects on face mask ventilation, easiness of laryngoscopy and intubation and the side effects were also measured.
Ninety patients completed the study. There was no statistically significant difference between the two groups regarding the CL grade ( < 0.1). However duration for intubation was significantly longer in Group A than Group B (31.4 ± 12.8 vs. 23.4 ± 40.7 sec, < 0.001). The degree of difficulty of face mask ventilation was significantly greater in Group A than Group B ( < 0.008). Attempts for successful intubation and manoeuvres for successful intubation were significantly more in Group A than B ( < 0.05). Trauma occurred in ten patients in Group A relative to no patients in Group B.
Use of a pre-sized obturator in infants with complete unilateral cleft palate does not improve the laryngoscopic view. However, it results in better face mask ventilation and easier and faster laryngoscopy and intubation.
腭裂患者的腭部缺损和牙列异常会使面罩通气和喉镜检查变得困难。本研究旨在评估喂养阻塞器对单侧完全性腭裂患者喉镜视野的影响。
90例计划接受单侧完全性腭裂一期修复术的非综合征型婴儿被随机分为A组（不使用喂养阻塞器）和B组（使用阻塞器进行诱导和插管）。主要目的是评估喂养阻塞器对喉镜检查时Cormack-Lehane分级的影响。还测量了对面罩通气、喉镜检查和插管的难易程度以及副作用的影响。
90例患者完成了研究。两组在CL分级方面无统计学显著差异（<0.1）。然而，A组的插管时间明显长于B组（31.4±12.8秒对23.4±40.7秒，<0.001）。A组面罩通气的困难程度明显大于B组（<0.008）。A组成功插管的尝试次数和成功插管的操作次数明显多于B组（<0.05）。A组有10例患者发生创伤，而B组无患者发生创伤。
在单侧完全性腭裂婴儿中使用预先定制的阻塞器并不能改善喉镜视野。然而，它能带来更好的面罩通气，使喉镜检查和插管更容易、更快速。
