Adamu Bilkisu, Yakubu Saidu Yusuf, Muhammad Rabiu Isah
Department of Anaesthesia, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria.
J West Afr Coll Surg. 2023 Jan-Mar;13(1):15-26. doi: 10.4103/jwas.jwas_265_22. Epub 2023 Jan 18.
Difficult airway management remains one of the most challenging clinical situations encountered by anaesthetists.
The study compared the effectiveness of the McGrath MAC video laryngoscope to the McCoy laryngoscope in patients with difficult airway.
Following the institution's ethical approval, the randomised controlled trial was conducted involving 74 adults with American Society of anaesthesiologists' physical status (ASA) grading of I-III scheduled for elective surgery. The Patients were randomised into either group MVL (McGrath MAC) or group MCC (McCoy) and intubated after preoxygenation with 100% oxygen and administration of IV propofol and suxamethonium. The Intubation Difficulty Score (IDS), success rate of intubation, time to intubation, number of optimising manoeuvres and complications was assessed. Statistical analysis was performed using the statistical Package for Social Sciences (SPSS) version 24.0 computer software (IBM SPSS Statistics, IBM Corp. NY, United States). Numerical and categorical data were compared using the student's -test and Chi square (χ) test respectively. A value of < 0.05 was considered statistically significant.
Lower IDS scores were noted in the McGrath group; 54.1% vs. 5.4% of patients had IDS score of 0 in the McGrath and McCoy groups respectively, ( < 0.001). Overall success rate was higher in the McGrath group (100% vs. 89.1%), = 0.040.
Lower IDS scores and improved intubation success rate was achieved with the McGrath compared with the McCoy laryngoscope in patients with predicted difficult airway. The McGrath has proved to be useful in managing patients with difficult airway.
困难气道管理仍然是麻醉医生面临的最具挑战性的临床情况之一。
本研究比较了麦格拉斯MAC视频喉镜与麦考伊喉镜在困难气道患者中的有效性。
在获得机构伦理批准后，进行了一项随机对照试验，纳入74例美国麻醉医师协会身体状况（ASA）分级为I - III级、计划进行择期手术的成年人。患者被随机分为MVL组（麦格拉斯MAC）或MCC组（麦考伊），在吸入100%氧气预充氧并静脉注射丙泊酚和琥珀胆碱后进行插管。评估插管困难评分（IDS）、插管成功率、插管时间、优化操作次数和并发症。使用社会科学统计软件包（SPSS）24.0版计算机软件（IBM SPSS Statistics，IBM公司，美国纽约）进行统计分析。数值数据和分类数据分别使用学生t检验和卡方（χ）检验进行比较。P值<0.05被认为具有统计学意义。
麦格拉斯组的IDS评分较低；麦格拉斯组和麦考伊组分别有54.1%和5.4%的患者IDS评分为0，（P<0.001）。麦格拉斯组的总体成功率更高（100%对89.1%），P = 0.040。
与麦考伊喉镜相比，对于预计有困难气道的患者，使用麦格拉斯喉镜可获得更低的IDS评分和更高的插管成功率。麦格拉斯喉镜已被证明在困难气道患者的管理中有用。
