Department of Anesthesiology and Pain Medicine, Cha Ilsan Medical Center, Cha University, 1205, Jungang-ro, Ilsandong-gu, Goyang-si 10414, Gyeonggi-do, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Hallym University Sacred Heart Hospital, 22, Gwanpyeong-ro 170 beon-gil, Dongan-gu, Anyang-si 14068, Gyeonggi-do, Republic of Korea.
Medicina (Kaunas). 2024 Aug 9;60(8):1285. doi: 10.3390/medicina60081285.
Obesity is associated with difficult or failed intubation attempts, making general anesthesia challenging for anesthesiologists to perform. The purpose of this study was to evaluate and compare the efficacy of a McCoy laryngoscope and a C-MAC D-blade video laryngoscope for intubation in obese patients with a body mass index (BMI) ≥ 35 kg/m. In total, 104 patients were randomly assigned to be intubated with a McCoy (McCoy group) or C-MAC D-blade video laryngoscope (C-MAC group). The primary outcome was intubation time. The secondary outcomes were vocal cord exposure time, vocal cord passage time, proportion of successful intubation, mask ventilation scale, intubation difficulty scale (IDS), percentage of glottis opening (POGO) score, and hemodynamic variables. Although the intubation time did not significantly differ, the C-MAC group showed shorter vocal cord exposure times and a higher rate of successful vocal cord exposure within 5 s. The IDS value was significantly lower in the C-MAC group than in the McCoy group. The proportion of patients who required an increase in lifting force during laryngoscopy was higher in the McCoy group than in the C-MAC group, which may explain the difference in MAP between the groups. Both the McCoy laryngoscope and the C-MAC D-blade video laryngoscope were useful during the intubation of obese patients. The C-MAC D-blade video laryngoscope might be more useful for obese patients in terms of hemodynamic stability.
肥胖与困难或失败的插管尝试有关，这使得麻醉师在为肥胖患者进行全身麻醉时面临挑战。本研究旨在评估和比较 McCoy 喉镜和 C-MAC D 刀片视频喉镜在 BMI≥35kg/m 的肥胖患者插管中的效果。共有 104 名患者被随机分为 McCoy 组（n=52）或 C-MAC D 刀片视频喉镜组（n=52）进行插管。主要结局指标为插管时间。次要结局指标包括声带暴露时间、声带通过时间、插管成功率、面罩通气分级、插管困难分级（IDS）、声门开放百分比（POGO）评分和血流动力学变量。尽管插管时间无显著差异，但 C-MAC 组的声带暴露时间更短，5 秒内成功暴露声带的比例更高。C-MAC 组的 IDS 值明显低于 McCoy 组。在喉镜检查期间需要增加提升力的患者比例在 McCoy 组中高于 C-MAC 组，这可能解释了两组之间 MAP 的差异。在肥胖患者的插管中，McCoy 喉镜和 C-MAC D 刀片视频喉镜都很有用。就血流动力学稳定性而言，C-MAC D 刀片视频喉镜可能对肥胖患者更有用。
