Department of Anesthesiology and Reanimation, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
Clinic of Anesthesiology and Reanimation, Tatvan State Hospital, Bitlis, Turkey.
Turk J Med Sci. 2022 Feb;52(1):216-221. doi: 10.3906/sag-2102-221. Epub 2022 Feb 22.
Being prepared for difficult airway (DA) is nevertheless of great importance. Failed or delayed tracheal intubation (TI) can increase morbidity and mortality, and the pediatric population is more prone to hypoxia. With the development of different types of videolaryngoscope (VL), these have become the device of choice in patients with DA. Our primary aim was to compare intubation times with D-blade and Macintosh blade of Storz C-MAC in a simulated pediatric DA scenario with this randomized controlled trial.
Children aged 1-5 years scheduled for elective surgery were included in the study. Patients were randomized into two groups: the D-Blade (n = 20) and MAC (n = 21) groups. All children underwent inhalational induction, and a neuromuscular relaxant was routinely administered (rocuronium 0.6 mg.kg-1). After the appropriate size of semirigid foam neck collar had been positioned around the patient's neck, the D-Blade group patients were intubated using a size 2 D-Blade, and the MAC group patients used a size 2 VL Macintosh blade. Intubation, time was measured. Patients' modified Cormack-Lehane system scores (MCLS), pre and postintubation blood pressure values and heart rates, and complications during intubation were recorded.
Demographic data were similar between the groups. There were also no significant differences in pre and postintubation heart rates, blood pressure, or SpO2 values (p > 0.05 for all). Mean intubation times for the MAC and D-Blade groups were 12.14 ± 2.79 s and 18.31 ± 10.86 s, respectively (p = 0.022). MCLS scores were lower in the D-Blade group (p = 0.030).
尽管如此，为困难气道（DA）做好准备仍然非常重要。失败或延迟的气管插管（TI）会增加发病率和死亡率，儿科人群更容易出现缺氧。随着不同类型的视频喉镜（VL）的发展，这些喉镜已成为 DA 患者的首选设备。我们的主要目的是通过这项随机对照试验比较在模拟儿科 DA 情况下 D 刀片和 Storz C-MAC 麦克intosh 刀片的插管时间。
本研究纳入了择期手术的 1-5 岁儿童。患者被随机分为两组：D 刀片（n = 20）和 MAC 组（n = 21）。所有儿童均接受吸入诱导，并常规给予神经肌肉阻滞剂（罗库溴铵 0.6 mg.kg-1）。在患者颈部周围放置适当尺寸的半刚性泡沫颈圈后，D 刀片组患者使用尺寸为 2 的 D 刀片进行插管，MAC 组患者使用尺寸为 2 的 VL Macintosh 刀片进行插管。测量插管时间。记录患者改良 Cormack-Lehane 系统评分（MCLS）、插管前后的血压值和心率以及插管期间的并发症。
两组的人口统计学数据相似。插管前后的心率、血压或 SpO2 值也无显著差异（p > 0.05）。MAC 组和 D 刀片组的平均插管时间分别为 12.14 ± 2.79 s 和 18.31 ± 10.86 s（p = 0.022）。D 刀片组的 MCLS 评分较低（p = 0.030）。
