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使用通道式King Vision视频喉镜改善Macintosh喉镜下声门视野受限患者的声门可视化效果评估:一项前瞻性观察研究。

Evaluation of the use of the channeled King Vision video laryngoscope in improving glottic visualisation in patients with limited glottic view with the Macintosh laryngoscope: A prospective observational study.

作者信息

Choudhary Jaya, Barai Arijit Kumar, Das Sandip, Mukherjee Nirjhar

机构信息

Department of Anaesthesiology and Pain Medicine, Medica Superspeciality Hospital, Kolkata, West Bengal, India.

出版信息

Indian J Anaesth. 2021 Dec;65(12):874-879. doi: 10.4103/ija.ija_905_21. Epub 2021 Dec 22.

Abstract

BACKGROUND AND AIMS

The role of King Vision videolaryngoscope (KVL) is well known in the anticipated difficult airway. However, its performance in patients with unanticipated restricted view of the glottis has never been investigated. The aim of this study was to evaluate the performance of KVL in patients with limited glottic view (POGO score <50%).

METHODS

Eighty-five patients fulfilling the inclusion criteria were included in this study. Laryngoscopy was performed in each patient with Macintosh blade followed by the channeled KVL. The laryngeal view obtained with each device was recorded using POGO score and Cormack--Lehane (CL) grade. After that, endotracheal intubation was attempted with the KVL. The haemodynamic parameters, the time taken for endotracheal tube placement and intubation, failure to intubate, modified intubation difficulty score and airway complications were also recorded.

RESULTS

There was a statistically significant improvement in the POGO scores with the use of KVL: 20 (0,40) vs 90 (40,100) ( < 0.001). The frequency of CL grade I and II increased from 63% with conventional laryngoscopy to 100% with the KVL. Although the time taken to obtain the best glottic view was significantly longer with the KVL as compared to the Macintosh blade ( < 0.001), the first attempt success rate was 97.65%.

CONCLUSION

Channeled KVL when used by experienced operators provides superior laryngeal view as compared to Macintosh laryngoscope in patients with restricted glottic view (POGO score <50%) without any major airway complications.

摘要

背景与目的

King Vision可视喉镜(KVL)在预计困难气道中的作用已广为人知。然而,其在声门视野意外受限患者中的表现从未被研究过。本研究的目的是评估KVL在声门视野受限患者(POGO评分<50%)中的性能。

方法

85例符合纳入标准的患者纳入本研究。每位患者先用Macintosh喉镜进行喉镜检查,然后使用带通道的KVL。使用POGO评分和Cormack-Lehane(CL)分级记录每种设备获得的喉镜视野。之后,尝试使用KVL进行气管插管。还记录了血流动力学参数、气管导管置入和插管所需时间、插管失败、改良插管困难评分和气道并发症。

结果

使用KVL后POGO评分有统计学显著改善:20(0,40)对90(40,100)(<0.001)。CL分级I级和II级的频率从传统喉镜检查时的63%增加到KVL时的100%。尽管与Macintosh喉镜相比,使用KVL获得最佳声门视野的时间明显更长(<0.001),但首次尝试成功率为97.65%。

结论

对于声门视野受限(POGO评分<50%)的患者,经验丰富的操作者使用带通道的KVL时,与Macintosh喉镜相比可提供更好的喉镜视野,且无任何重大气道并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b21/8820336/db0cda870efe/IJA-65-874-g001.jpg

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