Cook T M, Tuckey J P
Department of Anaesthesia, Royal United Hospital, Bath.
Anaesthesia. 1996 Oct;51(10):977-80. doi: 10.1111/j.1365-2044.1996.tb14971.x.
The view of the larynx using the Macintosh laryngoscope and the McCoy levering laryngoscope was assessed in 177 adult patients. The view with the McCoy blade in the neutral position and in the position (neutral or elevated) that gave the 'best' view were recorded. The McCoy blade in the neutral position was associated with a lower incidence of grade 1 views and a higher incidence of grade 2 views than the Macintosh blade. There was no difference in the incidence of grade 3 views. When views for each patient using the different blades were compared, the McCoy blade in the neutral position produced a worse view than the Macintosh blade (p < 0.0001). The view obtained with the McCoy blade in its 'best' position and the Macintosh blade were similar. In the 152 patients in whom the vocal cords were seen using the Macintosh blade, the view was worse using the McCoy blade in its 'best' position more often than it was better (p = 0.06). In 25 patients, the vocal cords could not be seen with the Macintosh blade; in these patients the view was better with the McCoy blade (the cords were visible) on 14 occasions and worse in one (p = 0.001). We conclude that the McCoy blade in its neutral position does not behave identically to the Macintosh blade. The McCoy blade is a useful aid to difficult intubation but should not replace the Macintosh blade as the first choice laryngoscope.
在177例成年患者中评估了使用麦金托什喉镜和麦考伊杠杆喉镜观察喉部的情况。记录了麦考伊喉镜处于中立位以及处于能获得“最佳”视野的位置（中立位或抬高位）时的视野情况。与麦金托什喉镜相比，麦考伊喉镜处于中立位时一级视野的发生率较低，二级视野的发生率较高。三级视野的发生率没有差异。当比较每位患者使用不同喉镜的视野时，麦考伊喉镜处于中立位时的视野比麦金托什喉镜差（p < 0.0001）。麦考伊喉镜处于“最佳”位置时获得的视野与麦金托什喉镜相似。在使用麦金托什喉镜能看到声带的152例患者中，麦考伊喉镜处于“最佳”位置时视野变差的情况比变好的情况更常见（p = 0.06）。在25例患者中，使用麦金托什喉镜看不到声带；在这些患者中，麦考伊喉镜能看到声带（视野更好）的情况有14次，视野更差的情况有1次（p = 0.001）。我们得出结论，麦考伊喉镜处于中立位时的表现与麦金托什喉镜不同。麦考伊喉镜对困难插管是一种有用的辅助工具，但不应取代麦金托什喉镜作为首选喉镜。
