Maheshwari Chandni, Kaur Haramritpal, Aggarwal Varun
INDIA.
Guru Gobind Singh Medical college, Faridkot, India.
Rom J Anaesth Intensive Care. 2023 Jan 14;29(1):16-21. doi: 10.2478/rjaic-2022-0003. eCollection 2022 Jul.
Securing the airway without morbidity is of prime importance. The difficult airway cart should have some advanced airway aids if not all. In this study we evaluated Airtraq laryngoscope and Intubating Laryngeal Mask Airway (ILMA) as intubating devices in novice users who were well accomplished in intubation using direct laryngoscope with Macintosh blade. Both the devices were used because of relatively lesser cost, portability and all in one compact design not requiring any setup. Methods: 60 consenting American Society of Anaesthesiology (ASA) Grade I and II patients, weighing 50 to 70 were randomly assigned to be intubated by Airtraq or ILMA. Primary Aim was to compare success rate and intubation time. Comparison of ease of intubation and postoperative pharyngeal morbidity were the secondary end points.
Success rate of intubation was higher in ILMA group (100%) than Airtraq (80%) [P = 0.0237]. However, in successful intubations the time for intubation was significantly less with Airtraq (Group A = 45.37 ± 27.55, Group I = 77.6 ± 31.85; P = 0.0003). No significant difference was noted in ease of intubation, number of optimizing manoeuvres to facilitate intubation and postoperative pharyngeal morbidity.
In Clinicians who are well versed with laryngoscopy using Macintosh blade but new to Airtraq and ILMA, success rate of intubation is higher with ILMA. Prolonged intubation time in ILMA should not deter its use in difficult airway scenarios because of the ability to ventilate through it.
在不造成并发症的情况下确保气道安全至关重要。困难气道推车即便不能配备所有先进气道辅助设备,也应具备一些此类设备。在本研究中,我们评估了Airtraq喉镜和气管插管型喉罩气道(ILMA)作为插管设备在新手使用者中的效果,这些新手使用麦金托什叶片直接喉镜进行插管操作已熟练掌握。使用这两种设备是因为它们成本相对较低、便于携带且一体化紧凑型设计无需任何组装。方法:60名美国麻醉医师协会(ASA)I级和II级、体重50至70公斤的同意参与研究的患者被随机分配接受Airtraq或ILMA插管。主要目的是比较成功率和插管时间。比较插管的难易程度和术后咽部并发症是次要终点。
ILMA组插管成功率(100%)高于Airtraq组(80%)[P = 0.0237]。然而,在成功插管的情况下,Airtraq的插管时间显著更短(A组 = 45.37 ± 27.55,I组 = 77.6 ± 31.85;P = 0.0003)。在插管难易程度、为便于插管进行的优化操作次数以及术后咽部并发症方面未观察到显著差异。
对于熟练使用麦金托什叶片喉镜但对Airtraq和ILMA不熟悉的临床医生而言,ILMA的插管成功率更高。ILMA插管时间较长,但因其具备通过它进行通气的能力,在困难气道情况下不应妨碍其使用。