Bhardwaj Mamta, Kumar Prashant, Kaur Kiranpreet
Department of Anesthesia and Critical Care, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India.
J Anaesthesiol Clin Pharmacol. 2024 Oct-Dec;40(4):598-604. doi: 10.4103/joacp.joacp_10_23. Epub 2024 Aug 16.
Traditionally, the sniffing position has been considered a standard head and neck position during direct laryngoscopy. The perfect head and neck position for video laryngoscopy has yet not been described. Hence, we planned the present study to compare the neutral and sniffing position for ease of intubation using Airtraq.
A total of 60 patients were randomized into two groups. Patients were intubated with their heads in neutral and sniffing positions in Group NP and SP, respectively. Ease of intubation was taken as a primary outcome. Laryngoscopy time, intubation time, percentage of glottic opening (POGO), the number of attempts for Airtraq and endotracheal tube, insertion of Airtraq, the success rate of intubation, optimization maneuvers, and complications were taken as secondary objectives. Data were analyzed using SPSS software, V.22.(1).
For ease of intubation, we used a visual analog scale (VAS) and Fremantle scores. VAS score (mm) in the median (interquartile range [IQR]) was 32 (24, 34) and 28 (24, 32) in NP and SP groups, respectively ( = 0.37). Twenty-four (80%) patients in NP and 23 (76.67%) patients in the SP group had a Fremantle score of F1 (full view; easy intubation). One (3.33%) patient in both groups had a score of F2 (full view; modified intubation). Five (16.67%) and six (20%) patients in NP and SP groups had P1 scores. Overall, there was no difference in Fremantle's score between the groups ( = 0.945). The number of attempts, optimization maneuvers, and complications were statistically comparable between the groups.
There is no difference in the ease of intubation between the neutral and sniffing position using the Airtraq optical laryngoscope.
传统上，嗅物位被认为是直接喉镜检查时标准的头颈部位置。视频喉镜检查的完美头颈部位置尚未有描述。因此，我们开展了本研究，以比较使用Airtraq喉镜时中立位和嗅物位在插管操作上的便利性。
总共60例患者被随机分为两组。NP组和SP组患者分别在头处于中立位和嗅物位的状态下进行插管。插管的便利性被视为主要结局。喉镜检查时间、插管时间、声门开口百分比（POGO）、Airtraq喉镜和气管导管的尝试次数、Airtraq喉镜的插入情况、插管成功率、优化操作以及并发症被视为次要目标。使用SPSS软件V.22.（1）对数据进行分析。
为评估插管的便利性，我们使用了视觉模拟量表（VAS）和弗里曼特尔评分。NP组和SP组的VAS评分（mm）中位数（四分位间距[IQR]）分别为32（24，34）和28（24，32）（P = 0.37）。NP组24例（80%）患者和SP组23例（76.67%）患者的弗里曼特尔评分为F1（视野完整；插管容易）。两组各有1例（3.33%）患者评分为F2（视野完整；改良插管）。NP组和SP组分别有5例（16.67%）和6例（20%）患者评分为P1。总体而言，两组间弗里曼特尔评分无差异（P = 0.945）。两组间尝试次数、优化操作和并发症在统计学上具有可比性。
使用Airtraq光学喉镜时，中立位和嗅物位在插管便利性上无差异。
