Kaur Kiranpreet, Raja Rameez, Kumar Prashant, Singh Roop, Vashishth Sumedha, Singh Harshil D, Bhardwaj Mamta, Singhal Suresh K
Department of Anaesthesiology and Critical Care, Rohtak, Haryana, India.
Department of Orthopaedics, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India.
J Anaesthesiol Clin Pharmacol. 2024 Jan-Mar;40(1):101-107. doi: 10.4103/joacp.joacp_89_22. Epub 2023 Jul 29.
Intubation with Macintosh requires flexing the lower cervical spine and extending the atlanto-occipital joint to create a "line of sight." Primary aim of study was to compare the extent of cervical spine movement during laryngoscopy using conventional Macintosh laryngoscope and Airtraq.
A total of 25 patients of either sex between the age group of 18 and 60 years, having American Society of Anesthesiologists (ASA) physical status of Grade-I and Grade-II, scheduled for elective surgery under image control requiring general anesthesia and intubation were enrolled. A baseline image of the lateral cervical spine including the first four cervical vertebrae was taken by an image intensifier. After administration of general anesthesia, laryngoscopy was first performed using a Macintosh laryngoscope and a second X-ray image of the lateral cervical spine was taken. The second laryngoscopy using a Airtraq laryngoscope was done and the third image of the lateral cervical spine was taken. Angles between occiput and C C and C C and C C and C and occiput and C were calculated. Atlanto-occipital distance (AOD) was calculated as the distance between occiput and C.
Macintosh showed greater cervical movement as compared with Airtraq but a significant difference in the movement was observed at C-C and C-C. Baseline mean AOD was 2.21 ± 1.25 mm, after Macintosh and Airtraq laryngoscopy was found to be 1.13 ± 0.60 and 1.6 ± 0.78 mm, respectively, and was found to be significant ( < 0.05).
We conclude that Airtraq allows intubation with less movement of the upper cervical spine makes Airtraq preferred equipment for intubation in patients with a potential cervical spine injury.
使用麦金托什喉镜进行气管插管时，需要弯曲下颈椎并伸展寰枕关节以形成“视线”。本研究的主要目的是比较使用传统麦金托什喉镜和Airraq喉镜进行喉镜检查时颈椎的活动程度。
纳入年龄在18至60岁之间、美国麻醉医师协会（ASA）身体状况为I级和II级、计划在影像引导下进行择期手术且需要全身麻醉和气管插管的25例患者，男女不限。通过影像增强器拍摄包括前四个颈椎的颈椎侧位基线图像。全身麻醉给药后，首先使用麦金托什喉镜进行喉镜检查，并拍摄颈椎侧位的第二张X线图像。然后使用Airraq喉镜进行第二次喉镜检查，并拍摄颈椎侧位的第三张图像。计算枕骨与C2、C2与C3、C3与C4以及C4与枕骨之间的角度。寰枕距离（AOD）计算为枕骨与C2之间的距离。
与Airraq相比，麦金托什喉镜显示颈椎活动度更大，但在C2-C3和C3-C4处观察到活动度有显著差异。基线平均AOD为2.21±1.25mm，使用麦金托什喉镜和Airraq喉镜检查后分别为1.13±0.60mm和1.6±0.78mm，差异有统计学意义（P<0.05）。
我们得出结论，Airraq在颈椎活动度较小的情况下即可完成气管插管，这使得Airraq成为有潜在颈椎损伤患者气管插管的首选设备。
