Department of Anesthesiology, Heritage Institute of Medical Sciences, Bhadwar, Varanasi, Uttar Pradesh, India.
J Anaesthesiol Clin Pharmacol. 2019 Jul-Sep;35(3):359-362. doi: 10.4103/joacp.JOACP_43_18.
During direct laryngoscopy (DL), intubation using armored endotracheal tubes (ETTs) requires help of bougies, stylets, or Magill's forceps, which leads to unnecessary prolongation in the intubation times. The channeled blade of King Vision (KV) video laryngoscope is likely to obviate the need of these equipments for a successful intubation using armored tubes.
After approval from Institutional Ethics Committee and informed consent, 100 patients were randomized to receive endotracheal intubation using armored ETTs either with KV video laryngoscope (VL) channeled blade or with Macintosh laryngoscope. Time to intubation, success rate, time for best glottis view, number of attempts, optimization maneuvers, or complications if any were recorded. Ease of device use was also assessed in terms of insertion, glottis visualization, and intubation. Continuous variables were tested using unpaired -test and categorical variables with Pearson's Chi-square test. ≤ 0.05 was considered significant.
First attempt success rate was 92% in group KV and 74% in group DL ( = 0.017). Time for successful intubation was less in group KV as compared with group DL ( < 0.0001). Optimization maneuvers such as "BURP" was needed in three patients of group KV and 11 patients of group DL ( = 0.0218). Bougie was needed in 13 patients of group DL and none from group KV ( = <0.001). Ease of device use was similar in the two groups.
KVVL offers faster intubating conditions for tracheal intubation requiring armored ETTs in comparison to DL using Macintosh blade.
在直接喉镜检查(DL)期间,使用金属丝加强型气管导管(ETT)进行插管需要导芯、管芯或麦吉利钳的辅助,这会导致插管时间不必要的延长。King Vision(KV)视频喉镜的带通道叶片可能无需这些设备就能使用金属丝加强型导管成功插管。
经机构伦理委员会批准并获得知情同意后,100例患者被随机分为两组,分别使用带KV视频喉镜(VL)带通道叶片的金属丝加强型ETT或麦金托什喉镜进行气管插管。记录插管时间、成功率、最佳声门视野时间、尝试次数、优化操作或并发症(如有)。还从插入、声门可视化和插管方面评估了设备使用的难易程度。连续变量采用不成对t检验,分类变量采用Pearson卡方检验。P≤0.05被认为具有统计学意义。
KV组首次尝试成功率为92%,DL组为74%(P = 0.017)。与DL组相比,KV组成功插管时间更短(P < 0.0001)。KV组有3例患者和DL组有11例患者需要进行“BURP”等优化操作(P = 0.0218)。DL组有13例患者需要使用导芯,KV组无一例需要(P = <0.001)。两组设备使用的难易程度相似。
与使用麦金托什叶片的DL相比,KVVL为需要使用金属丝加强型ETT的气管插管提供了更快的插管条件。