Kumar Atit, Singh Rakesh Bahadur, Doneria Deepika, Shukla Usha, Ansari Mohammad Aleem
Anesthesiology and Critical Care, Uttar Pradesh University of Medical Sciences, Etawah, IND.
Cureus. 2024 Nov 30;16(11):e74869. doi: 10.7759/cureus.74869. eCollection 2024 Nov.
For patients having cervical spine instability, stabilization of the neck is crucial to prevent further damage to the spinal cord, which can make laryngoscopy challenging. Specialized tools like McCoy blade direct laryngoscope (Surgitech, India) and BPL video laryngoscope (BPL Medical Technologies Pvt. Ltd., India) enhance airway management in these groups of patients. This study compared the efficacy and safety of direct laryngoscopy with McCoy blade and BPL video laryngoscopy in cervical spine surgery patients.
This randomized prospective comparative study was performed on 60 patients of ASA physical status I & II, either sex, 18 to 65 years of age, undergoing elective cervical spine surgery under general anesthesia. Patients were divided into groups B (BPL) and M (McCoy), with 30 patients in each group. After successful intubation, time for intubation, Modified Cormack Lehane grading, intubation difficulty score, ease of intubation, and hemodynamic parameters were recorded at numerous intervals.
The mean duration for tracheal intubation was longer in Group B (36.30 ± 19.75 seconds) as compared to Group M (28.07 ± 10.19 seconds), which was statistically significant. The MCL grading, in Group B, was 76.67% and in Group M 46.67% of patients achieved MCL grade 1, which was statistically significant (p = 0.049), indicating better visualization of the vocal cords in Group B. Intubation difficulty score, in Group B, was 56.67% patients, and in Group M, only 23.33% patients achieved a score of 0 and it was also statically significant (p=0.042). 86.67% of patients in Group B and 60.00% of patients in Group M had ease of intubation scores 1, which were statistically significant (p = 0.040). All hemodynamic parameters were found statically insignificant in both groups.
This study revealed that BPL video laryngoscopy took more time for intubation but provided better vocal cord visualization and easier intubation, while McCoy blade intubation took less time for tracheal intubation and all hemodynamic parameters remained stable in both groups.
对于颈椎不稳定的患者，颈部稳定对于防止脊髓进一步损伤至关重要，而这可能会使喉镜检查具有挑战性。像麦考伊叶片直接喉镜（印度 Surgitech 公司）和 BPL 视频喉镜（印度 BPL 医疗技术私人有限公司）这样的专业工具可改善这类患者的气道管理。本研究比较了麦考伊叶片直接喉镜和 BPL 视频喉镜在颈椎手术患者中的有效性和安全性。
本随机前瞻性对照研究对 60 例年龄在 18 至 65 岁、ASA 身体状况为 I 级和 II 级的择期颈椎手术患者进行，性别不限，均在全身麻醉下进行。患者分为 B 组（BPL）和 M 组（麦考伊），每组 30 例。成功插管后，在多个时间点记录插管时间、改良的科马克 - 莱哈尼分级、插管困难评分、插管难易程度及血流动力学参数。
B 组气管插管的平均持续时间（36.30±19.75 秒）长于 M 组（28.07±10.19 秒），差异有统计学意义。B 组患者中达到改良科马克 - 莱哈尼分级 1 级的比例为 76.67%，M 组为 46.67%，差异有统计学意义（p = 0.049），表明 B 组声带视野更好。B 组患者插管困难评分为 0 分的比例为 56.67%，M 组仅为 23.33%，差异也有统计学意义（p = 0.042）。B 组 86.67%的患者和 M 组 60.00%的患者插管难易程度评分为 1 分，差异有统计学意义（p = 0.040）。两组所有血流动力学参数差异均无统计学意义。
本研究表明，BPL 视频喉镜插管时间较长，但声带视野更好且插管更容易，而麦考伊叶片插管气管插管时间较短，两组所有血流动力学参数均保持稳定。
