Affiliated Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng, Inner Mongolia, China.
Affiliated Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng, Inner Mongolia, China; Department of Anesthesiology, Chifeng Municipal Hospital, Chifeng, Inner Mongolia, China.
J Clin Anesth. 2024 Nov;98:111590. doi: 10.1016/j.jclinane.2024.111590. Epub 2024 Aug 22.
The video laryngoscope (VLS) has been proven to be an effective insertion device for airway management. However, no laryngoscope has been specifically designed for the placement of the laryngeal mask airway (LMA). We improved the current VLS and developed a novel VLS method. This study aimed to evaluate the clinical efficacy of an improved VLS for inserting a flexible laryngeal mask airway (F-LMA) compared with the standard blind method.
One hundred and fifty-seven patients who underwent F-LMA insertion under general anesthesia were randomly assigned to either the standard blind insertion technique (group B) or VLS -assisted insertion (group VL). First attempt success rates were recorded. Secondary outcomes included oropharyngeal leakage pressure (OLP), fiberoptic view, insertion time, position adjustment, reinsertion rate, and postoperative airway morbidity.
The first-attempt success rate was higher in group VL than that in group B (99% vs. 86%; p = 0.002). The OLP was significantly higher in the VLS-guided technique (26.4 ± 5.1 vs 23.8 ± 4.4 cmHO, p = 0.002). The fiberoptic view was significantly better in the group VL (p < 0.001) and required less readjustment and reinsertion to establish an effective airway (p < 0.001). The insertion time was shorter in the group B than that in group VL (33.9 vs 41.3 s, p < 0.001). Hemodynamic stress responses and postoperative airway complications did not differ between the two groups.
The new VLS-guided insertion technology has a high success rate, achieves greater OLP, and provides an ideal anatomical position with minimal adjustment, without increasing the risk of hemodynamic stress or adverse events.
Chinese Clinical Trial Registry (registration number: ChiCTR2300075866; https://www.chictr.org.cn).
视频喉镜（VLS）已被证明是一种有效的气道管理插入设备。然而，目前还没有专门为放置喉罩气道（LMA）而设计的喉镜。我们改进了现有的 VLS，并开发了一种新的 VLS 方法。本研究旨在评估与标准盲探法相比，改良 VLS 用于插入软喉罩气道（F-LMA）的临床效果。
157 例在全身麻醉下接受 F-LMA 插入的患者被随机分为标准盲探插入技术（B 组）或 VLS 辅助插入（VL 组）。记录首次尝试成功率。次要结果包括口咽漏压（OLP）、纤维光学视野、插入时间、位置调整、重新插入率和术后气道并发症。
VL 组首次尝试成功率高于 B 组（99%比 86%；p=0.002）。VLS 引导技术的 OLP 明显更高（26.4±5.1 比 23.8±4.4 cmH2O，p=0.002）。VL 组的纤维光学视野明显更好（p<0.001），需要更少的调整和重新插入以建立有效的气道（p<0.001）。B 组的插入时间短于 VL 组（33.9 比 41.3 s，p<0.001）。两组之间的血流动力学应激反应和术后气道并发症没有差异。
新的 VLS 引导插入技术具有高成功率，实现更大的 OLP，并提供最小调整的理想解剖位置，而不会增加血流动力学应激或不良事件的风险。
中国临床试验注册中心（注册号：ChiCTR2300075866；https://www.chictr.org.cn）。
