Mathew Amit, Mathai Roy Rajan, Theodore Bernice, Chandy Jacob, Yadav Bijesh, Singh Georgene, Sahajanandan Raj
Department of Anaesthesia, Christian Medical College, Vellore, Tamil Nadu, India.
Department of Anaesthesia, Christian Fellowship Hospital, Oddanchatram, Tamil Nadu, India.
Anesth Essays Res. 2022 Jul-Sep;16(3):289-295. doi: 10.4103/aer.aer_81_22. Epub 2022 Oct 31.
The use of a double-lumen endotracheal tube is one of the common anesthetic techniques for operations in the thoracic cavity. However, when compared to a single-lumen tube, placement of a double-lumen tube is technically more difficult as a result of which it takes more time to insert and is associated with more complications such as mucosal injury, hoarseness, and sore throat, even in patients with no anticipated airway difficulty. The CMAC D-blade that is usually used in patients with anticipated airway difficulty, could assist in smooth and quick placement of double-lumen tube (DLT) even in patients with no anticipated airway difficulty.
This study aimed to evaluate the effectiveness of the C-MAC D-blade in reducing the time taken to visualize the glottis and intubate patients with normal airway with a double-lumen tube.
This was a prospective open-label randomized control trial in a tertiary hospital.
Seventy-three consenting adult patients with physical status classes I and II, as determined by the American Society of Anesthesiologists, scheduled to undergo elective thoracotomy, were randomly allocated to receive either C-MAC D-blade (Group D) or Macintosh blade (Group M). The primary objective was to compare the time taken for visualization of the glottis and intubation.
Chi-square/Fisher's exact test and -test were used for statistical analysis.
Seventy-three patients were randomized (Group D = 36; Group M = 37). Time to visualize the glottic structures (4.56 ± 2.396 s vs. 7.27 ± 4.891 s, = 0.01) was significantly better in Group D; however, the mean intubation time was comparable (55.92 ± 18.749 s vs. 51.08 ± 15.269 s, = 0.61).
C-MAC D-blade videolaryngoscope offers a better glottic view and lesser time to visualize glottis when compared with the Macintosh laryngoscope. However, the time taken to insert the DLT after visualization was longer. We infer that there is no advantage in the routine use of C-MAC D-blade for DLT insertion in patients with no anticipated airway difficulty.
使用双腔气管导管是胸腔手术中常用的麻醉技术之一。然而，与单腔气管导管相比，双腔气管导管的放置在技术上更困难，因此插入所需时间更长，并且即使在没有预期气道困难的患者中也会出现更多并发症，如黏膜损伤、声音嘶哑和咽痛。通常用于有预期气道困难患者的CMAC D型喉镜，即使在没有预期气道困难的患者中也能协助双腔气管导管顺利快速放置。
本研究旨在评估C-MAC D型喉镜在缩短可视声门时间以及为气道正常的患者插入双腔气管导管的有效性。
这是一项在三级医院进行的前瞻性开放标签随机对照试验。
73名经美国麻醉医师协会判定为身体状况I级和II级的成年患者，同意接受择期开胸手术，被随机分配接受C-MAC D型喉镜（D组）或麦金托什喉镜（M组）。主要目的是比较可视声门和插管所需时间。
采用卡方检验/费舍尔精确检验和t检验进行统计分析。
73名患者被随机分组（D组 = 36；M组 = 37）。D组可视声门结构的时间（4.56 ± 2.396秒对7.27 ± 4.891秒，P = 0.01）明显更短；然而，平均插管时间相当（55.92 ± 18.749秒对51.08 ± 15.269秒，P = 0.61）。
与麦金托什喉镜相比，C-MAC D型视频喉镜能提供更好的声门视野，可视声门时间更短。然而，可视声门后插入双腔气管导管的时间更长。我们推断，对于没有预期气道困难的患者，常规使用C-MAC D型喉镜插入双腔气管导管并无优势。
