A Prospective Comparative Study of Laryngeal Glottic View Using the Vie Scope^® versus Standard Macintosh Laryngoscope in Morbidly Obese Patients.

IF 2.3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES Therapeutics and Clinical Risk Management Pub Date : 2023-01-01 DOI:10.2147/TCRM.S377585

Tomasz Gaszynski, Pavel Michalek, Pawel Ratajczyk

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Abstract

Background: The visualization of the glottis may be inadequate in morbidly obese patients when a standard Macintosh blade laryngoscope (MCL) is used. The Vie Scope^® (VS) is a novel type laryngoscope consisting of a straight, enclosed, illuminated tube that offers intubation via a bougie using the paraglossal technique. In this prospective, nonrandomized comparative study, we tested the research hypothesis that the VS may improve visualization of the glottic larynx in comparison to the MCL.

Materials and methods: After obtaining institutional ethics committee approval, 60 morbidly obese patients (BMI >40 kg/m²) undergoing elective non-head and neck surgery were included in the study. After induction of general anesthesia (GA), the glottic visualization was performed using the two laryngoscopes in succession, first MCL size 3 or 4 followed by the VS and was assessed using the modified Cormack-Lehane scale. Tracheal intubation was performed using the VS The first pass intubation success and the total success rate was recorded only for the VS Intubation time was not measured because of the paired study design.

Results and discussion: Mean demographic data included: age 41.9±8.2 years, height 171.2±10.2 cm, weight 129.9±21.6 kg, BMI 44.95±3.85 kg/m². Using MCL, Cormack-Lehane grade 1 was observed in 36 (60%) cases; grade 2 in 7/60 (11.6%); grade 3 in 13/60 (21.7%); and grade 4 in 4/60 (6.7%). Poor laryngeal views represented by grades 3 and 4 were observed in 28.4% of patients with the MCL. Grades obtained with the VS were all grade 1 (100%). The first attempt intubation success was in 58/60 (96.7%) with the VS. No complications were observed.

Conclusion: The Vie Scope^® laryngoscope, using the paraglossal technique of tracheal intubation, significantly improves visualization of the vocal cords in morbidly obese patients compared to the standard Macintosh laryngoscope.

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使用Vie®喉镜与标准Macintosh喉镜观察病态肥胖患者喉门的前瞻性比较研究。

背景:病态肥胖患者使用标准麦金塔刀片喉镜(MCL)时，声门的可视化可能不够。Vie Scope®(VS)是一种新型喉镜，由一根直的、封闭的、发光的管子组成，通过滑翔伞技术提供气管插管。在这项前瞻性、非随机比较研究中，我们验证了VS比MCL可以改善声门喉部视觉的研究假设。材料与方法:经机构伦理委员会批准，择期行非头颈部手术的病态肥胖患者(BMI >40 kg/m2) 60例纳入研究。全麻诱导(GA)后，连续使用两台喉镜进行声门显像，首先是MCL大小为3或4，然后是VS，并使用改进的Cormack-Lehane量表进行评估。使用VS进行气管插管，由于采用配对研究设计，仅记录VS的首次插管成功率和总成功率，未测量插管时间。结果与讨论:平均人口学资料包括:年龄41.9±8.2岁，身高171.2±10.2 cm，体重129.9±21.6 kg, BMI 44.95±3.85 kg/m2。使用MCL, 36例(60%)患者观察到Cormack-Lehane 1级;2级7/60 (11.6%);3年级13/60 (21.7%);4/60成绩4级(6.7%)。在28.4%的MCL患者中观察到3级和4级喉镜表现不佳。通过VS获得的成绩均为1级(100%)。首次插管成功率为58/60(96.7%)，无并发症发生。结论:与标准Macintosh喉镜相比，Vie Scope®喉镜采用气管插管的副压缩技术，显著改善了病态肥胖患者声带的可视性。

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来源期刊

Therapeutics and Clinical Risk Management HEALTH CARE SCIENCES & SERVICES-

CiteScore

4.80

自引率

3.60%

发文量

139

审稿时长

16 weeks

期刊介绍： Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas. The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature. As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication. The journal does not accept study protocols, animal-based or cell line-based studies.