非通道视频喉镜与直接喉镜改善ASA 1和2患者血流动力学和插管时间，一项双盲随机对照试验

IF 2.7 3区医学 Q1 EMERGENCY MEDICINE

American Journal of Emergency Medicine Pub Date : 2025-05-22 DOI:10.1016/j.ajem.2025.05.036

Peter B. Ghattas MSc, EDPM EFIC, Samir E. Elansary MD, Ashraf M. Mohamed MD, Mahmoud S. Anwar MD

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引用次数: 0

摘要

在2022年，美国麻醉医师协会（ASA）将间接视频喉镜纳入其困难气道算法，以帮助困难插管。为了确定在非挑战性病例中常规使用视频喉镜（VL）的潜在优势，我们进行了一项研究，比较其对血流动力学、插管时间和空腹血糖（FBS）的影响，并与直接喉镜（DL）进行比较。方法：这是一项双盲、前瞻性、随机、对照试验，在一所大学医院进行择期手术的ASA I至II级患者。患者被随机分配到DL或VL，气管内管通过导管导管预先固定在叶片上。主要结果是插管后平均血压（MBP）的差异。次要结局包括插管时间、Cormack-Lehane分级、FBS水平和其他血流动力学差异。本研究注册于（pactr.samrc.ac.za），注册号为PACTR202305589924304。结果80例患者分别采用DL （n = 40）和VL （n = 40）插管，预定型导管间接视频喉镜下的MBP、HR、DBP、插管时间和Cormack-Lehane分级均明显优于直接喉镜下，平均值分别为78.83 vs 90.50 mmhg、84.78 vs 92.13、78.83 vs 90.50 mmhg、15.63 vs 17.28 s，而直接喉镜下对FBS、收缩压和饱和度的影响无显著差异。结论间接视频喉镜在患者血流动力学特别是MBP、插管时间方面优于直接喉镜，FBS方面差异无统计学意义。

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Non-channelled video laryngoscopy versus direct laryngoscopy for improving hemodynamics and intubation time in ASA 1 and 2 patients, a double blinded randomized controlled trial

Background

In 2022, the American Society of Anaesthesiologists (ASA) included indirect video laryngoscopy in their difficult airway algorithm to aid in difficult intubation. To determine the potential advantages of routinely using video laryngoscopy (VL) in nonchallenging cases, we conducted a study to examine its effects on hemodynamics, intubation time and fasting blood sugar (FBS) in comparison with direct laryngoscopy (DL).

Methodology

This was a double blinded, prospective, randomized, controlled trial in a university hospital included ASA I to II patients undergoing elective surgery. Patients were randomly assigned to either DL or VL with an endotracheal tube preshaped to the blade through a stylet. The primary outcome was the difference in the mean blood pressure (MBP) post intubation. Secondary outcomes included intubation time, Cormack–Lehane grade, FBS levels and other hemodynamic differences. The study was registered at (pactr.samrc.ac.za), number PACTR202305589924304.

Results

80 patients were enrolled and intubated with either DL (n = 40) or VL (n = 40), MBP, HR, DBP, intubation time and Cormack–Lehane grade were significantly better with indirect video laryngoscopy with pre-shaped stylet than with direct laryngoscopy, with mean values of 78.83 vs 90.50 mmhg, 84.78 vs 92.13, 78.83 vs 90.50 mmhg, 15.63 vs 17.28 s respectively, but the effects of direct laryngoscopy on FBS, SBP, and saturation were not significantly different.

Conclusion

Indirect video laryngoscopy is superior to direct laryngoscopy regarding patient's hemodynamics specially the MBP, intubation time with no significant difference regarding FBS.

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来源期刊

American Journal of Emergency Medicine 医学-急救医学

CiteScore

6.00

自引率

5.60%

发文量

730

审稿时长

42 days

期刊介绍： A distinctive blend of practicality and scholarliness makes the American Journal of Emergency Medicine a key source for information on emergency medical care. Covering all activities concerned with emergency medicine, it is the journal to turn to for information to help increase the ability to understand, recognize and treat emergency conditions. Issues contain clinical articles, case reports, review articles, editorials, international notes, book reviews and more.