{"title":"Disposcope 内窥镜与 Macintosh 喉镜在喉镜检查方面的比较","authors":"Ziyu Gu, Liang Zhu, Zhouquan Wu","doi":"10.1007/s44254-023-00036-0","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>Disposcope is a novel fibreoptic intubation device that allows visualization of the glottis without aligning the oral, pharyngeal, and tracheal axes. This device may offer advantages in improving glottis exposure, or reducing hemodynamic disturbance, and minimizing movement of the upper cervical spine (C-spine). In this study, we aimed to evaluate laryngoscopy using Disposcope compared to Macintosh laryngoscope.</p><h3>Methods</h3><p>This study enrolled 60 adult patients (American Society of Anesthesiologists physical status 1 and 2), both male and female, underwent lumbar spine surgery, scheduled for general anesthesia with endotracheal intubation. We compared the Cormack and Lehane grade, hemodynamic response, and the maximal change in the angle between adjacent cervical vertebrae and cumulative upper C-spine movement between Disposcope and Macintosh laryngoscope. A crossover trial design was employed, with half of the patients being exposed to the glottis using the Macintosh laryngoscope first, followed by the Disposcope, and vice versa for the other half.</p><h3>Results</h3><p>The intubation time in the Disposcope group was significantly lower than that in the Macintosh laryngoscope group (<i>P</i> < 0.01). Using the Disposcope resulted in improved views of the glottis (Z = −4.82, <i>P</i> < 0.01). Cormack and Lehane grade I views were achieved with the Disposcope in more patients than the Macintosh laryngoscope (36.7% versus 13.3%, <i>P</i> < 0.01). Grade II views were obtained in 58.3% of patients with the Disposcope, whereas a lower percentage (43.3%) was observed with the Macintosh laryngoscope. The incidence of grade III views was significantly lower with the Disposcope than with the Macintosh laryngoscope (5% versus 33.3%, <i>P</i> < 0.01). Additionally, there was significantly less hemodynamic disturbance (mean arterial pressure and heart rate) with the Disposcope compared to the Macintosh laryngoscope (<i>P</i> < 0.01). Finally, the median cumulative upper C-spine movement was greater with the Macintosh laryngoscope than with the Disposcope (26.9° versus 9.4°, <i>P</i> < 0.01).</p><h3>Conclusions</h3><p>In comparison to the Macintosh laryngoscope, the Disposcope provided improved views of the glottis and resulted in less hemodynamic disturbance and movement of the upper C-spine during laryngoscopy in patients.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 4","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00036-0.pdf","citationCount":"0","resultStr":"{\"title\":\"Comparison of Disposcope endoscope with Macintosh laryngoscope for laryngoscopy\",\"authors\":\"Ziyu Gu, Liang Zhu, Zhouquan Wu\",\"doi\":\"10.1007/s44254-023-00036-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p>Disposcope is a novel fibreoptic intubation device that allows visualization of the glottis without aligning the oral, pharyngeal, and tracheal axes. This device may offer advantages in improving glottis exposure, or reducing hemodynamic disturbance, and minimizing movement of the upper cervical spine (C-spine). In this study, we aimed to evaluate laryngoscopy using Disposcope compared to Macintosh laryngoscope.</p><h3>Methods</h3><p>This study enrolled 60 adult patients (American Society of Anesthesiologists physical status 1 and 2), both male and female, underwent lumbar spine surgery, scheduled for general anesthesia with endotracheal intubation. We compared the Cormack and Lehane grade, hemodynamic response, and the maximal change in the angle between adjacent cervical vertebrae and cumulative upper C-spine movement between Disposcope and Macintosh laryngoscope. A crossover trial design was employed, with half of the patients being exposed to the glottis using the Macintosh laryngoscope first, followed by the Disposcope, and vice versa for the other half.</p><h3>Results</h3><p>The intubation time in the Disposcope group was significantly lower than that in the Macintosh laryngoscope group (<i>P</i> < 0.01). Using the Disposcope resulted in improved views of the glottis (Z = −4.82, <i>P</i> < 0.01). Cormack and Lehane grade I views were achieved with the Disposcope in more patients than the Macintosh laryngoscope (36.7% versus 13.3%, <i>P</i> < 0.01). Grade II views were obtained in 58.3% of patients with the Disposcope, whereas a lower percentage (43.3%) was observed with the Macintosh laryngoscope. The incidence of grade III views was significantly lower with the Disposcope than with the Macintosh laryngoscope (5% versus 33.3%, <i>P</i> < 0.01). Additionally, there was significantly less hemodynamic disturbance (mean arterial pressure and heart rate) with the Disposcope compared to the Macintosh laryngoscope (<i>P</i> < 0.01). Finally, the median cumulative upper C-spine movement was greater with the Macintosh laryngoscope than with the Disposcope (26.9° versus 9.4°, <i>P</i> < 0.01).</p><h3>Conclusions</h3><p>In comparison to the Macintosh laryngoscope, the Disposcope provided improved views of the glottis and resulted in less hemodynamic disturbance and movement of the upper C-spine during laryngoscopy in patients.</p></div>\",\"PeriodicalId\":100082,\"journal\":{\"name\":\"Anesthesiology and Perioperative Science\",\"volume\":\"1 4\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-11-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://link.springer.com/content/pdf/10.1007/s44254-023-00036-0.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anesthesiology and Perioperative Science\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://link.springer.com/article/10.1007/s44254-023-00036-0\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anesthesiology and Perioperative Science","FirstCategoryId":"1085","ListUrlMain":"https://link.springer.com/article/10.1007/s44254-023-00036-0","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的Disposcope 是一种新型纤维光学插管装置，无需对准口腔、咽部和气管轴即可观察声门。这种装置在改善声门暴露、减少血液动力学紊乱和最大限度地减少上颈椎（C-spine）运动方面可能具有优势。本研究旨在评估使用 Disposcope 与 Macintosh 喉镜进行喉镜检查的效果。本研究共纳入了 60 名接受腰椎手术的成年患者（美国麻醉医师协会体能状态 1 级和 2 级），包括男性和女性，他们都计划接受气管插管全身麻醉。我们比较了 Disposcope 喉镜和 Macintosh 喉镜的 Cormack 和 Lehane 分级、血液动力学反应、相邻颈椎之间角度的最大变化以及累积的上 C 脊柱移动。采用交叉试验设计，一半患者先使用 Macintosh 喉镜暴露声门，然后再使用 Disposcope，另一半患者则相反。使用 Disposcope 可改善声门视野（Z = -4.82, P < 0.01）。使用 Disposcope 获得 Cormack 和 Lehane I 级视野的患者多于 Macintosh 喉镜（36.7% 对 13.3%，P < 0.01）。58.3%的患者使用 Disposcope 获得了 II 级视野，而使用 Macintosh 喉镜获得 II 级视野的比例较低（43.3%）。使用 Disposcope 时，III 级视野的发生率明显低于 Macintosh 喉镜（5% 对 33.3%，P < 0.01）。此外，与 Macintosh 喉镜相比，使用 Disposcope 时血液动力学紊乱（平均动脉压和心率）明显减少（P < 0.01）。结论与 Macintosh 喉镜相比，Disposcope 可提供更好的声门视野，并在喉镜检查过程中减少血液动力学干扰和患者上 C 脊柱的移动。
Comparison of Disposcope endoscope with Macintosh laryngoscope for laryngoscopy
Purpose
Disposcope is a novel fibreoptic intubation device that allows visualization of the glottis without aligning the oral, pharyngeal, and tracheal axes. This device may offer advantages in improving glottis exposure, or reducing hemodynamic disturbance, and minimizing movement of the upper cervical spine (C-spine). In this study, we aimed to evaluate laryngoscopy using Disposcope compared to Macintosh laryngoscope.
Methods
This study enrolled 60 adult patients (American Society of Anesthesiologists physical status 1 and 2), both male and female, underwent lumbar spine surgery, scheduled for general anesthesia with endotracheal intubation. We compared the Cormack and Lehane grade, hemodynamic response, and the maximal change in the angle between adjacent cervical vertebrae and cumulative upper C-spine movement between Disposcope and Macintosh laryngoscope. A crossover trial design was employed, with half of the patients being exposed to the glottis using the Macintosh laryngoscope first, followed by the Disposcope, and vice versa for the other half.
Results
The intubation time in the Disposcope group was significantly lower than that in the Macintosh laryngoscope group (P < 0.01). Using the Disposcope resulted in improved views of the glottis (Z = −4.82, P < 0.01). Cormack and Lehane grade I views were achieved with the Disposcope in more patients than the Macintosh laryngoscope (36.7% versus 13.3%, P < 0.01). Grade II views were obtained in 58.3% of patients with the Disposcope, whereas a lower percentage (43.3%) was observed with the Macintosh laryngoscope. The incidence of grade III views was significantly lower with the Disposcope than with the Macintosh laryngoscope (5% versus 33.3%, P < 0.01). Additionally, there was significantly less hemodynamic disturbance (mean arterial pressure and heart rate) with the Disposcope compared to the Macintosh laryngoscope (P < 0.01). Finally, the median cumulative upper C-spine movement was greater with the Macintosh laryngoscope than with the Disposcope (26.9° versus 9.4°, P < 0.01).
Conclusions
In comparison to the Macintosh laryngoscope, the Disposcope provided improved views of the glottis and resulted in less hemodynamic disturbance and movement of the upper C-spine during laryngoscopy in patients.
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