Kılınç Leyla, Çınar Ayşe Surhan
Department of Anesthesiology and Reanimation, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
Sisli Etfal Hastan Tip Bul. 2019 Jun 24;53(2):143-147. doi: 10.14744/SEMB.2019.55631. eCollection 2019.
We aim to investigate intubation conditions, intubation times, and hemodynamic response with the GlideScope video laryngoscope or the Macintosh direct laryngoscope for orotracheal intubation in children older than one year.
Eighty patients aged 1-12 years, scheduled to undergo elective surgery under general anesthesia with endotracheal intubation were included in a prospective, single-blinded, randomized trial. Exclusion criteria were risk of pulmonary aspiration, craniofacial malformation, difficult intubation, emergency surgery, cardiovascular disease, respiratory disease, and hemodynamic instability. After standard anesthesia induction, patients were randomized into two groups. The group G patients (n=40) were intubated with the GlideScope and the group M patients (n=40) were intubated with the Macintosh laryngoscope. Intubation time, number of attempts, Cormack-Lehane score, airway maneuvers, and visual analog score were recorded. Hemodynamic variables were recorded before and after anesthesia induction, at intubation, and 1., 3., and 5. minutes after intubation. Student's t-test, Mann-Whitney U test, and the χ test were used for statistical analysis, with p<0.05 considered significant.
The demographic data, operation time and hemodynamic parameters were similar between the two groups. The intubation time was longer in Group G than Group M. The incidence of Cormack-Lehane score 1 was higher in Group G than Group M while Cormack-Lehane score 2 was higher in Group M.
We concluded that the GlideScope video laryngoscope provided better glottis visualization, but prolonged intubation time. There was no superiorty on hemodynamic effect with the video laryngoscope.
我们旨在研究使用GlideScope视频喉镜或Macintosh直接喉镜对1岁以上儿童进行经口气管插管时的插管条件、插管时间和血流动力学反应。
80例年龄在1至12岁之间、计划在全身麻醉下行气管插管择期手术的患者纳入一项前瞻性、单盲、随机试验。排除标准包括肺误吸风险、颅面畸形、插管困难、急诊手术、心血管疾病、呼吸系统疾病和血流动力学不稳定。在标准麻醉诱导后，患者被随机分为两组。G组患者（n = 40）使用GlideScope进行插管，M组患者（n = 40）使用Macintosh喉镜进行插管。记录插管时间、尝试次数、Cormack-Lehane评分、气道操作和视觉模拟评分。在麻醉诱导前、插管时以及插管后1、3和5分钟记录血流动力学变量。采用Student's t检验、Mann-Whitney U检验和χ检验进行统计分析，p < 0.05被认为具有统计学意义。
两组的人口统计学数据、手术时间和血流动力学参数相似。G组的插管时间比M组长。G组Cormack-Lehane评分1级的发生率高于M组，而M组Cormack-Lehane评分2级的发生率更高。
我们得出结论，GlideScope视频喉镜能更好地显露声门，但插管时间延长。视频喉镜在血流动力学效应方面并无优势。
