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手动轴向稳定固定颈椎患者中使用可视喉镜(无通道刀片)和托人视频喉镜进行气管插管的比较:一项随机临床试验。

Comparison of Tracheal Intubation Using King Vision (Non-channeled Blade) and Tuoren Video Laryngoscopes in Patients With Cervical Spine Immobilization by Manual In-Line Stabilization: A Randomized Clinical Trial.

作者信息

Ramesh Killo, Srinivasan Gnanasekaran, Bidkar Prasanna U

机构信息

Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND.

出版信息

Cureus. 2023 Aug 14;15(8):e43471. doi: 10.7759/cureus.43471. eCollection 2023 Aug.

Abstract

BACKGROUND

Glottic visualization on cervical immobilization with manual in-line stabilization (MILS) might be challenging in individuals with cervical spine injuries. We compared non-channeled King Vision video laryngoscope (VL) (Ambu GmbH, Bad Nauheim, Germany) with Tuoren video laryngoscope (Henan Tuoren Medical Device, Zhengzhou, China) for endotracheal intubation in patients with cervical spine immobilization.

METHODS

A total of 124 patients undergoing elective surgery under general anesthesia were included in this study. After induction of general anesthesia, patients were randomized into two groups (62 each): group K (non-channeled blade of King Vision video laryngoscope) and group T (Tuoren video laryngoscope). Cervical spine immobilization was achieved with manual in-line stabilization. The success of the first pass intubation, the time required to intubate, glottic visualization, and intubation difficulty score (IDS) were recorded.

RESULTS

The first-attempt success rate of intubation was 95.2% (59 out of 62 patients) in group K and 90.3% (56 out of 62 patients) in group T, which were comparable. The mean glottic visualization time was significantly less with group T (12.74 ± 6.32 seconds) compared to group K (17.92 ± 4.24 seconds). Intubation time was significantly faster with group K (18.79 ± 5.857 seconds) compared to group T (27.21 ± 8.514 seconds). Both video laryngoscopes provided good grades of glottic visualization.

CONCLUSIONS

We conclude that the performance of the Tuoren video laryngoscope is similar to the King Vision video laryngoscope in terms of first-attempt intubation success rate and glottic visualization score in patients with cervical spine immobilization by manual in-line stabilization. Although glottic visualization time was shorter with Tuoren VL, we could achieve faster intubation with King Vision VL.

摘要

背景

对于颈椎损伤患者,在采用手动轴向固定(MILS)进行颈椎固定时,声门可视化可能具有挑战性。我们比较了非通道型King Vision视频喉镜(VL)(德国巴特瑙海姆的Ambu有限公司)和托人视频喉镜(中国郑州的河南托人医疗器械公司)在颈椎固定患者气管插管中的应用。

方法

本研究共纳入124例接受全身麻醉下择期手术的患者。全身麻醉诱导后,患者被随机分为两组(每组62例):K组(King Vision视频喉镜非通道型镜片)和T组(托人视频喉镜)。采用手动轴向固定实现颈椎固定。记录首次插管成功率、插管所需时间、声门可视化情况及插管难度评分(IDS)。

结果

K组插管首次尝试成功率为95.2%(62例患者中的59例),T组为90.3%(62例患者中的56例),两者具有可比性。与K组(17.92±4.24秒)相比,T组的平均声门可视化时间显著更短(12.74±6.32秒)。与T组(27.21±8.514秒)相比,K组的插管时间显著更快(18.79±5.857秒)。两种视频喉镜均能提供良好的声门可视化等级。

结论

我们得出结论,在通过手动轴向固定对颈椎固定患者进行首次插管成功率和声门可视化评分方面,托人视频喉镜的表现与King Vision视频喉镜相似。尽管托人视频喉镜的声门可视化时间较短,但使用King Vision视频喉镜我们能实现更快的插管。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a28/10499184/22c1dbf9e767/cureus-0015-00000043471-i01.jpg

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