GlideScope视频喉镜与C-MAC视频喉镜在治疗可能插管困难的肥胖患者中的可行性和结果

Abd-Elfattah Daboun, E. Ismail, Hassanain Hamzawy, A. Emara
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引用次数: 2

摘要

背景:气管插管困难和失败仍然是与麻醉实践相关的发病率和死亡率的主要原因。为了提高肥胖患者气道困难的插管成功率,我们引入了视频喉镜。目的本研究的目的是比较GlideScope和C-MAC视频喉镜在预期插管困难的肥胖患者中的可行性和结果。患者与方法本研究为前瞻性比较单盲研究,于2013年1月至2015年1月在沙特阿拉伯比沙国王阿卜杜拉医院进行。其中包括60名预期插管困难的肥胖患者。他们被随机分为两组:GlideScope组和C-MAC组。评估所有患者的人口学特征、插管参数和结果。结果两组患者一般特征及血流动力学无明显差异。然而,与C-MAC组相比,GlideScope组有明显更好的声门视图。GlideScope组总插管时间和首次插管时间明显短于C-MAC组(分别为32.43±2.40和28.70±2.15 s vs. 40.40±5.07和34.80±2.92 s)。与GlideScope组相比,C-MAC组首次插管失败的发生率明显更高(分别为33.3%和10.0%)。与C-MAC组相比,GlideScope组的总体满意度显著提高。结论与C-MAC相比,GlideScope具有更好的声门视野、更短的插管总次数和首次插管次数、更高的首次插管成功率。这些结果提倡在有潜在插管困难的肥胖患者中使用GlideScope。
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Feasibility and outcome of GlideScope videolaryngoscope versus C-MAC videolaryngoscope in the management of obese patients with potentially difficult intubation
Background Difficult and failed tracheal intubation remains a leading cause of morbidity and mortality related to anesthesia practice. Videolaryngoscopes were introduced into practice to increase the success rate of intubation in obese patients with difficult airway. Aim The aim of this study was to compare GlideScope and C-MAC videolaryngoscopes in obese patients with anticipated difficult intubation as regards feasibility and outcome. Patients and methods The study was designed as a prospective comparative single-blind study, which was conducted at King Abdullah Hospital, Bisha, KSA, during the period from January 2013 to January 2015. It included 60 obese patients with anticipated difficult intubation. They were randomly divided into two equal groups: the GlideScope group and the C-MAC group. All patients were assessed for demographic characteristics, intubation parameters, and outcome. Results There were no significant differences between the two groups as regards general characteristics and hemodynamics. However, there was a significantly better glottic view in the GlideScope group compared with the C-MAC group. There was a significantly shorter total intubation time and first attempt intubation time in the GlideScope group compared with the C-MAC group (32.43±2.40 and 28.70±2.15 s vs. 40.40±5.07 and 34.80±2.92 s, respectively). The incidence of failure of the first intubation attempt was significantly higher in the C-MAC group compared with the GlideScope group (33.3 vs. 10.0%, respectively). Overall satisfaction was significantly better in the GlideScope group compared with the C-MAC group. Conclusion GlideScope had better glottic view, shorter total intubation and first attempt intubation times, and higher success rate of first intubation attempt compared with C-MAC. These results advocate the use of GlideScope in obese patients with potentially difficult intubation.
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