Chilkoti Geetanjali Tolia, Bhandari Pallav, Mohta M, Saxena Ashok Kumar, Kapoor Ruchi
Department of Anesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Shahdara, Delhi, 110095 India.
Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3191-3198. doi: 10.1007/s12070-023-03828-9. Epub 2023 Jun 15.
To compare the efficacy of conventional Macintosh laryngoscope with Airtraq videolaryngoscope for visualization of laryngeal structures to rule out recurrent laryngeal nerve injury at the end of thyroidectomy. This randomized double-blind control study was conducted following IEC-Human approval, prospective CTRI registration and written informed consent from participants. Patients of either sex, aged 18-65 years, ASA grade I/II, scheduled for thyroidectomy under GA were included. Group DL underwent direct laryngoscopy using Macintosh blade whereas group VL underwent laryngoscopy using Airtraq® videolaryngoscope. CL(Cormack-Lehane) grade of laryngeal view, time taken to achieve optimal view, haemodynamic parameters, Patient reactivity score(PRS) and complications were noted. Unpaired t-test, chi-square test were used. A total of 73 patients were included for study with 38 in group DL and 35 in group VL. The grade of laryngeal view was found to be significantly better with Airtraq® VL compared to Macintosh laryngoscope without the application of BURP ( < 0.05). In the DL group, 34.2% (n = 13) had a CL grade I, 36.8% (n = 14) had CL grade 2A, 13.2% had CL grade 2B (n = 5) and 15.8% (n = 6) had CL Grade 3 at the end of thyroidectomy. On the contrary, in the VL Group, 71.5% (n = 25) of the participants had a CL Grade I; whereas, 20% (n = 7) had a CL Grade 2A, 5.7% (n = 2) had CL grade 2B and 2.8% (n = 1) of participants had CL grade 3. The mean "time taken to achieve optimal view' was comparable between the two groups (DL = 39.16 ± 105.53 s vs. VL = 38.89 ± 20.69 s) ( = 0.988).The haemodynamic parameters, Patient reactivity score and complications were comparable between the two groups. The performance of Airtraq® videolaryngoscope, a channelled VL is better than conventional Macintosh laryngoscope in terms of the optimal glottic view obtained to rule out recurrent laryngeal nerve palsy at the end of thyroidectomy.
比较传统麦金托什喉镜与艾克瑞可视喉镜在甲状腺切除术后用于观察喉部结构以排除喉返神经损伤的效果。本随机双盲对照研究在获得国际电工委员会（IEC）对人体研究的批准、前瞻性临床试验注册中心（CTRI）注册以及参与者书面知情同意后进行。纳入年龄在18 - 65岁、ASA分级为I/II级、计划在全身麻醉下进行甲状腺切除术的男女患者。DL组使用麦金托什喉镜叶片进行直接喉镜检查，而VL组使用艾克瑞可视喉镜进行喉镜检查。记录喉镜视野的Cormack - Lehane（CL）分级、获得最佳视野所需时间、血流动力学参数、患者反应评分（PRS）及并发症。采用非配对t检验、卡方检验。共73例患者纳入研究，DL组38例，VL组35例。结果发现，在未应用BURP的情况下，与麦金托什喉镜相比，艾克瑞可视喉镜的喉镜视野分级明显更好（P < 0.05）。在DL组，甲状腺切除术后，34.2%（n = 13）为CL I级，36.8%（n = 14）为CL 2A级，13.2%（n = 5）为CL 2B级，15.8%（n = 6）为CL 3级。相反，在VL组，71.5%（n = 25）的参与者为CL I级；而20%（n = 7）为CL 2A级，5.7%（n = 2）为CL 2B级，2.8%（n = 1）的参与者为CL 3级。两组“获得最佳视野所需时间”的平均值相当（DL = 39.16 ± 105.53秒 vs. VL = 38.89 ± 20.69秒）（P = 0.988）。两组的血流动力学参数、患者反应评分及并发症相当。在甲状腺切除术后获得最佳声门视野以排除喉返神经麻痹方面，带通道的可视喉镜艾克瑞可视喉镜的性能优于传统麦金托什喉镜。
