Elattar Hussein, Abdel-Rahman Islam, Ibrahim Muhammad, Kocz Remek, Raczka Michelle, Kumar Anuj, Senbruna Baiba, Gensler Tara, Lerman Jerrold
Department of Anesthesiology, Oishei Children's Outpatient Center, 1001 Main St. Suite K-3502, Buffalo 14203, United States of America; Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, New York, United States of America.
Department of Anesthesiology, Oishei Children's Outpatient Center, 1001 Main St. Suite K-3502, Buffalo 14203, United States of America; Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, New York, United States of America.
J Clin Anesth. 2020 Mar;60:57-61. doi: 10.1016/j.jclinane.2019.08.009. Epub 2019 Aug 23.
The Miller and Wis-Hipple size 1 blades are widely used for laryngoscopy in children and the C-MAC straight blade is used increasingly in young children, although the glottic views with these blades have not been compared. To determine whether the glottic views with these blades are equivalent.
Equivalent study.
Operating room.
96 children <2 years, ASA 1 or 2, elective surgery requiring orotracheal intubation.
Direct laryngoscopy with the Miller and Wis-Hipple or C-MAC (videolaryngoscope and direct view) straight blades size 1; photographs of the glottic opening.
Percent of glottic opening (POGO) was measured using a standardized scale by a blinded investigator. Heart rate, systolic blood pressure and hemoglobin oxygen saturation were measured before and after laryngoscopy.
The POGO scores with the four blades/views were equivalent (fewer than 20% of the views yielded POGO scores <80). However, a post hoc comparison of the POGO scores yielded significant differences (P = 0.0001); the C-MAC videolaryngoscope view yielded significantly better scores than the Miller, Wis-Hipple and direct C-MAC views (P = 0.0009, 0.0002 and 0.0001 respectively). The POGO score with the Miller blade was superior to that with the direct C-MAC view (P = 0.024). No adverse events or complications occurred.
The four blades/glottic views were equivalent, although a post hoc analysis demonstrated that the glottic view with the C-MAC videolaryngoscope was superior overall and the view with the Miller size 1 was superior to that with the direct C-MAC view.
米勒（Miller）1号刀片和威斯-希普尔（Wis-Hipple）1号刀片广泛用于儿童喉镜检查，而C-MAC直刀片在幼儿中的使用也越来越多，尽管尚未对这些刀片的声门视野进行比较。旨在确定这些刀片的声门视野是否相当。
等效性研究。
手术室。
96名2岁以下儿童，美国麻醉医师协会（ASA）分级为1或2级，因择期手术需要经口气管插管。
使用米勒、威斯-希普尔或C-MAC（视频喉镜和直视）1号直刀片进行直接喉镜检查；拍摄声门开口照片。
由一名不知情的研究者使用标准化量表测量声门开口百分比（POGO）。在喉镜检查前后测量心率、收缩压和血红蛋白氧饱和度。
四种刀片/视野的POGO评分相当（少于20%的视野POGO评分<80）。然而，POGO评分的事后比较产生了显著差异（P = 0.0001）；C-MAC视频喉镜视野的评分显著优于米勒、威斯-希普尔和直接C-MAC视野（分别为P = 0.0009、0.0002和0.0001）。米勒刀片的POGO评分优于直接C-MAC视野（P = 0.024）。未发生不良事件或并发症。
四种刀片/声门视野相当，尽管事后分析表明，C-MAC视频喉镜的声门视野总体上更优，而米勒1号刀片的视野优于直接C-MAC视野。
