Miller 喉镜与 McGrath-MAC 视频喉镜在直接观察声门开口时的效果比较。
Comparison of the Effectiveness of the Miller Laryngoscope and the McGrath-MAC Video Laryngoscope in Direct Visualization of the Glottic Opening.
机构信息
Department of Anesthesiology and Reanimation, Trabzon Faculty of Medicine, University of Health Sciences, Trabzon 61080, Turkey.
Department of Anesthesiology and Reanimation, Zonguldak Bülent Ecevit University, Zonguldak 67100, Turkey.
出版信息
Medicina (Kaunas). 2023 Dec 28;60(1):62. doi: 10.3390/medicina60010062.
: Placing the laryngoscope blade directly under the epiglottis (known as the direct view (DV) method) during videolaryngoscopy offers a superior view of the glottis when compared to the indirect method of lifting the epiglottis by positioning the Macintosh blade tip over the vallecula. While there are few studies comparing glottic views using Miller and Macintosh blades in pediatric patients, we have not come across such a study in adults. In this study, we aimed to compare the effectiveness and hemodynamic responses of the Miller laryngoscope and the McGrath-MAC videolaryngoscope (VL) in visualizing the glottic opening using the DV method. : A prospective study was conducted between August and December 2022 at XXX Hospital on 85 patients scheduled for surgical procedures involving endotracheal intubation. Patients were divided into two groups: Miller laryngoscope (Group M) and McGrath-MAC videolaryngoscope (Group VL) and intubated using the direct lifting method of the epiglottis. Hemodynamic responses before and after induction, as well as during laryngoscopy, intubation time, number of attempts, Cormack and Lehane (C&L) score, percentage of glottic opening (POGO), duration of the view of the opening, and need for external laryngeal pressure during intubation were recorded. : Both laryngoscopes showed similar effectiveness in terms of POGO and C&L score when used with the direct lifting method of the epiglottis. The median POGO values according to the DV method were 80% in Group M and 70% in Group VL ( = 0.099). Hemodynamic responses, intubation time, number of attempts, duration of view of the glottis opening, and the need for external laryngeal pressure were similar between the groups. : Due to its ability to provide effective intubation conditions, we believe that the McGrath-MAC VL, when used with the indirect view method, can also be utilized in anesthesia practices alongside the DV method.
在视频喉镜检查中，将喉镜叶片直接置于会厌下方（称为直接视图（DV）方法），与通过将 Macintosh 叶片尖端置于杓状软骨之间来提起会厌的间接方法相比，提供了更好的声门视图。虽然很少有研究比较小儿患者使用 Miller 和 Macintosh 叶片的声门视图，但我们在成人中没有遇到过这样的研究。在这项研究中，我们旨在比较 Miller 喉镜和 McGrath-MAC 视频喉镜（VL）在使用 DV 方法直接提起会厌时观察声门开口的有效性和血流动力学反应。
一项前瞻性研究于 2022 年 8 月至 12 月在 XXX 医院进行，共纳入 85 例计划行涉及气管内插管的手术的患者。患者分为两组：Miller 喉镜（M 组）和 McGrath-MAC 视频喉镜（VL 组），并使用直接提起会厌的方法进行插管。记录诱导前后以及喉镜检查、插管时间、尝试次数、Cormack 和 Lehane（C＆L）评分、声门开口百分比（POGO）、开口观察时间以及插管时对外科喉压的需求。
两种喉镜在使用直接提起会厌的方法时，在 POGO 和 C＆L 评分方面均显示出相似的有效性。根据 DV 方法，M 组的中位数 POGO 值为 80%，VL 组为 70%（= 0.099）。两组的血流动力学反应、插管时间、尝试次数、声门开口观察时间和对外科喉压的需求相似。
由于其能够提供有效的插管条件，我们认为，当使用间接视图方法时，McGrath-MAC VL 也可以与 DV 方法一起用于麻醉实践。
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