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在新冠疫情期间,由穿戴防护装备的麻醉医生使用插管箱,比较C-MAC和麦格拉斯MAC可视喉镜用于气道正常患者插管的效果:一项前瞻性随机研究

Comparison of C-MAC and McGrathMAC Videolaryngoscopes for Intubation in Patients with Normal Airway by Donned Anaesthesiologists Using an Intubation Box During COVID-19 Pandemic: A Prospective, Randomized Study.

作者信息

Gupta Nishkarsh, Sarma Riniki, Vig Saurabh, Kumar Vinod, Gupta Anju, Mishra Seema

机构信息

Department of Onco-Anaesthesia and Palliative Medicine, Dr BRAIRCH, AIIMS, New Delhi, India.

Department of Onco-Anaesthesia and Palliative Medicine, NCI, AIIMS, New Delhi, India.

出版信息

Turk J Anaesthesiol Reanim. 2022 Aug;50(4):255-260. doi: 10.5152/TJAR.2021.21251.

Abstract

OBJECTIVE

Intubation is a highly aerosol-generating procedure. Recent airway management guidelines advocate the use of appropriate personal protective equipment, videolaryngoscope, and "intubation box" while intubating a suspected or infected coronavirus patient. We undertook a study to compare C-MAC videolaryngoscope with McGrath videolaryngoscope for tracheal intubation using an intubation box by donned anaesthesiologists.

METHODS

The patients were randomly allocated to 2 groups by computer-generated random numbers, depending upon the videolaryngoscope used. In group C, C-MAC videolaryngoscope (n=30) was used, whereas McGrath videolaryngoscope was used in group M (n=30). The primary outcome was the total time required for successful intubation. The secondary outcomes included the number of attempts required, Cormack and Lehane grade, the percentage of glottis opening score, the difficulty faced while using the device, and the user's preference.

RESULTS

The time to intubation was 57.17 ± 19.98 seconds with C-MAC videolaryngoscope as compared to 57.93 ± 14.92 seconds with McGrath. Both the devices had a good percentage of glottis opening score. Twelve patients in each group were found to have a Cormack and Lehane grade of 1. The time to glottis visualization was more with McGrath than with C-MAC although not significant (23.8 ± 14.03 vs 20.10 ± 10.78 seconds). Both the devices were easy to use.

CONCLUSIONS

Both C-MAC and McGrath videolaryngoscopes are equally effective devices for intubation by a donned anaesthesiologist using an intubation box. McGrath with a disposable blade should be preferred for intubation in these conditions.

摘要

目的

气管插管是一种产生大量气溶胶的操作。近期的气道管理指南提倡在为疑似或感染冠状病毒的患者进行气管插管时使用适当的个人防护设备、视频喉镜和“插管箱”。我们进行了一项研究,比较穿戴防护装备的麻醉医生使用插管箱时,C-MAC视频喉镜与麦格拉斯视频喉镜在气管插管中的应用情况。

方法

根据所使用的视频喉镜,通过计算机生成随机数将患者随机分为两组。C组使用C-MAC视频喉镜(n = 30),而M组使用麦格拉斯视频喉镜(n = 30)。主要结局指标是成功插管所需的总时间。次要结局指标包括所需尝试次数、科马克和莱哈尼分级、声门开放评分百分比、使用设备时遇到的困难以及使用者的偏好。

结果

使用C-MAC视频喉镜时插管时间为57.17±19.98秒,而使用麦格拉斯视频喉镜时为57.93±14.92秒。两种设备的声门开放评分百分比都很高。每组均有12例患者的科马克和莱哈尼分级为1级。虽然差异不显著,但麦格拉斯视频喉镜观察到声门的时间比C-MAC视频喉镜长(23.8±14.03秒对20.10±10.78秒)。两种设备都易于使用。

结论

对于穿戴防护装备的麻醉医生使用插管箱进行气管插管,C-MAC和麦格拉斯视频喉镜同样有效。在这些情况下,应优先选择带有一次性刀片的麦格拉斯视频喉镜进行插管。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdfb/9524438/ad55ba6bb46f/tjar-50-4-255_f001.jpg

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