Rao Madhu, Budania Lokvendra S, Chamala Vamsidhar, Goyal Kush
Department of Anesthesia, Kasturba Medical College, Manipal, Karnataka, India.
J Anaesthesiol Clin Pharmacol. 2018 Apr-Jun;34(2):188-192. doi: 10.4103/joacp.JOACP_330_16.
Laryngeal mask airway (LMA) CTrach™ and Airtraq videolaryngoscopes are useful for endotracheal intubation in patients with limited cervical spine movements and other predicted difficult airways. We aimed to compare LMA CTrach™ and Airtraq videolaryngoscopes as conduits for endotracheal intubation in patients with simulated limitation of cervical spine movements by manual in-line stabilization (MILS).
This was a prospective, randomized study including 50 patients undergoing elective surgeries under general anesthesia. Patients were assigned to undergo intubation using Airtraq ( = 25) or LMA CTrach™ ( = 25) by an experienced anesthesiologist, while MILS was provided. Laryngoscopy and intubation were compared in terms of time taken to obtain optimal laryngeal view, successful intubation, total time, percentage of glottis opening (POGO) score, maneuvers required for optimal laryngeal view and alignment of endotracheal tube, and number of attempts and complications. An integrated score was calculated to classify the attempt as good, restricted, or poor.
Time taken to obtain optimal laryngeal view, successful intubation, and total time in both groups were comparable. POGO score >50% was seen in 25 and 21 patients in Groups A and C. Seventy-six percent and ninety-six percent in Groups A and C, respectively, had a good integrated score; 6% and 1% had restricted score; none had a poor score; and the difference between them was statistically significant ( = 0.042).
LMA CTrach™ and Airtraq are similar with respect to time taken for obtaining optimal laryngeal view, successful intubation, and total time when used for intubation in patients with simulated limitation of cervical spine movements.
喉罩气道(LMA)CTrach™和Airtraq可视喉镜对于颈椎活动受限及其他预计存在困难气道的患者进行气管插管很有用。我们旨在比较LMA CTrach™和Airtraq可视喉镜作为在模拟颈椎活动受限患者中通过手动直线固定(MILS)进行气管插管的通道。
这是一项前瞻性随机研究,纳入50例接受全身麻醉下择期手术的患者。患者被分配由经验丰富的麻醉医生使用Airtraq(n = 25)或LMA CTrach™(n = 25)进行插管,同时进行MILS。比较喉镜检查和插管在获得最佳喉镜视野所需时间、插管成功情况、总时间、声门开口百分比(POGO)评分、获得最佳喉镜视野和气管导管对齐所需的操作以及尝试次数和并发症方面的情况。计算综合评分以将尝试分类为良好、受限或不佳。
两组获得最佳喉镜视野的时间、插管成功时间和总时间相当。A组和C组分别有25例和21例患者的POGO评分>50%。A组和C组分别有76%和96%的患者综合评分良好;6%和1%的患者评分受限;无人评分不佳;且两组之间的差异具有统计学意义(P = 0.042)。
在模拟颈椎活动受限的患者中用于插管时,LMA CTrach™和Airtraq在获得最佳喉镜视野的时间、插管成功情况和总时间方面相似。