Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
BMC Anesthesiol. 2019 Jul 31;19(1):137. doi: 10.1186/s12871-019-0811-x.
A tracheal tube stylet can be used to assist successful tracheal intubation, especially during videolaryngoscopic intubation because videolaryngoscopes with a Macintosh-type blade such as McGrath® MAC videolaryngoscope have more acute angle than conventional Macintosh laryngoscope. However, the use of a stylet during tracheal intubation can raise concerns about stylet-induced postoperative airway complications, such as sore throat, subglottic injury, and hoarseness. In this study, we compared the incidence of postoperative airway complications after McGrath® MAC videolaryngoscopic intubation with versus without a stylet in patients with a high Mallampati score.
In 104 patients with Mallampati score III or IV and who were scheduled for lumbar or thoracic spine surgery, McGrath® MAC videolaryngoscopic intubation was performed either with a stylet (group S, n = 52) or without a stylet (group N, n = 52). The primary outcome measure was the incidences of sore throat evaluated at 1 and 24 h postoperatively. Secondary outcome measures were the incidences of subglottic injury and postoperative hoarseness.
The incidence of CL grade III in group S and N was 3.8 and 5.8%, respectively. No patient showed CL grade IV. The incidences of sore throat at 1 (26.9 vs 19.2%, P = 0.485) and 24 h (17.3 vs 13.5%, P = 0.786, respectively) postoperatively were not significantly different between the group S and N. However, the incidence of subglottic injury was significantly higher in the group S, compared with the group N (65.4 vs 42.3%, P = 0.030). The incidence of postoperative hoarseness did not differ significantly between the two groups.
The use of a stylet during McGrath® MAC videolaryngoscopic intubation did not have a significant impact on the incidence of postoperative sore throat in patients with a high Mallampati score. Avoiding the use of a stylet during intubation with McGrath® MAC videolaryngoscope may reduce the incidence of subglottic injury in such patients.
Clinical Research Information Service (identifier: KCT0002427 , date of registration: June 12, 2017).
气管导管管芯可用于辅助气管插管成功，尤其是在视频喉镜插管时，因为具有麦克intosh 型叶片的视频喉镜（如麦格ath® MAC 视频喉镜）的角度比传统麦克intosh 喉镜更锐利。然而，在气管插管过程中使用管芯可能会引起对管芯引起的术后气道并发症的担忧，例如咽痛、声门下损伤和声音嘶哑。在这项研究中，我们比较了在 Mallampati 评分较高的患者中，使用和不使用管芯进行麦格ath® MAC 视频喉镜插管后的术后气道并发症发生率。
在 104 例 Mallampati 评分 III 或 IV 并计划行腰椎或胸椎手术的患者中，使用麦格ath® MAC 视频喉镜进行插管，管芯组（S 组，n = 52）或不使用管芯（N 组，n = 52）。主要观察指标是术后 1 小时和 24 小时评估的咽痛发生率。次要观察指标是声门下损伤和术后声音嘶哑的发生率。
S 组和 N 组的 CL 分级 III 发生率分别为 3.8%和 5.8%。无患者出现 CL 分级 IV。S 组和 N 组术后 1 小时（26.9%比 19.2%，P = 0.485）和 24 小时（17.3%比 13.5%，P = 0.786）的咽痛发生率无显著差异。然而，S 组的声门下损伤发生率显著高于 N 组（65.4%比 42.3%，P = 0.030）。两组术后声音嘶哑的发生率无显著差异。
在 Mallampati 评分较高的患者中，使用麦格ath® MAC 视频喉镜插管时使用管芯并不会显著增加术后咽痛的发生率。避免在麦格ath® MAC 视频喉镜插管时使用管芯可能会降低此类患者的声门下损伤发生率。
临床研究信息服务（标识符：KCT0002427，注册日期：2017 年 6 月 12 日）。
