Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Anesthesiology and Pain Medicine, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Republic of Korea.
Medicine (Baltimore). 2022 Nov 11;101(45):e31775. doi: 10.1097/MD.0000000000031775.
Inserting a double-lumen endotracheal tube (DLT) poses more challenge than inserting a single-lumen tube. The C-MAC D-blade videolaryngoscope is a useful alternative to the direct laryngoscope. However, no study has compared its performance with that of the McCoy laryngoscope, which has a hyperangulated blade tip similar to that of the C-MAC D-blade. We aimed to compare the performance of the C-MAC D-blade videolaryngoscope with that of the McCoy laryngoscope in DLT intubation.
In this prospective randomized controlled study, 90 patients requiring DLT intubation were randomly allocated to either the C-MAC D-blade videolaryngoscope group (group C, n = 47) or McCoy laryngoscope group (group M, n = 43). During intubation, the percentage of glottic opening, modified Cormack-Lehane grade, time taken for intubation, malposition of the bronchial lumen, and hemodynamic parameters were recorded. After intubation, we assessed the intubation difficulty scale score and, a postoperative sore throat in the recovery room.
The time taken for intubation was 35.85 ± 10.77 seconds and 33.18 ± 11.97 seconds in groups C and M, respectively (P = .269). The modified Cormack-Lehane grade was significantly lower in group C than in group M (P = .000). Percentage of glottic opening was significantly higher in group C (79.36 ± 13.42%) than in group M (53.49 ± 29.83%) (P = .000). The intubation difficulty scale score was significantly lower in group C than in group M (P = .030). There were no significant differences between the 2 groups in terms of malposition status, hemodynamic parameters, or visual analog scale score for a postoperative sore throat.
Although the time taken for intubation was comparable between the 2 intubation devices, the C-MAC D-blade videolaryngoscope facilitated glottis visualization and reduced the intubation difficulty scale better than the McCoy laryngoscope in patients undergoing DLT intubation.
插入双腔气管内导管（DLT）比插入单腔气管内导管更具挑战性。C-MAC D 叶片视频喉镜是直接喉镜的一种有用替代品。然而，尚无研究比较其与 McCoy 喉镜的性能，后者的叶片尖端具有超角度，类似于 C-MAC D 叶片。我们旨在比较 C-MAC D 叶片视频喉镜与 McCoy 喉镜在 DLT 插管中的性能。
在这项前瞻性随机对照研究中，90 名需要 DLT 插管的患者被随机分配到 C-MAC D 叶片视频喉镜组（C 组，n=47）或 McCoy 喉镜组（M 组，n=43）。在插管过程中，记录声门张开的百分比、改良 Cormack-Lehane 分级、插管时间、支气管腔位置不当以及血流动力学参数。插管后，评估插管难度量表评分和恢复室术后咽痛。
C 组和 M 组的插管时间分别为 35.85±10.77 秒和 33.18±11.97 秒（P=0.269）。C 组改良 Cormack-Lehane 分级明显低于 M 组（P=0.000）。C 组声门张开百分比明显高于 M 组（79.36±13.42%比 53.49±29.83%）（P=0.000）。C 组插管难度量表评分明显低于 M 组（P=0.030）。两组在插管位置不当、血流动力学参数或术后咽痛视觉模拟评分方面无显著差异。
虽然两种插管装置的插管时间相当，但在进行 DLT 插管的患者中，C-MAC D 叶片视频喉镜比 McCoy 喉镜更有利于声门可视化，并降低插管难度量表评分。
