Shikani Optical Stylet versus Macintosh Laryngoscope for Intubation in Patients Undergoing Surgery for Cervical Spondylosis: A Randomized Controlled Trial

被引:15
作者
Xu, Mao [1 ]
Li, Xiao-Xi [2 ]
Guo, Xiang-Yang [1 ]
Wang, Jun [1 ]
机构
[1] Peking Univ Third Hosp, Dept Anesthesiol, Beijing 100191, Peoples R China
[2] Peking Univ Canc Hosp & Inst, Minist Educ, Dept Anesthesiol, Key Lab Carcinogenesis & Translat Res, Beijing 100142, Peoples R China
关键词
Airway; Cervical Spondylosis; Intubation; Laryngoscope; Optical Stylet; LEFT-MOLAR APPROACH; TRACHEAL INTUBATION; DIFFICULT AIRWAY; GLIDESCOPE(R); AIRTRAQ(R);
D O I
10.4103/0366-6999.198926
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Airway management is critical in patients with cervical spondylosis, a population with a high incidence of difficult airway. Intubation with Shikani Optical Stylet (SOS) has become increasingly popular in difficult airway. We compared the effects of intubation with SOS versus Macintosh laryngoscope (MLS) in patients undergoing surgery for cervical spondylosis. Methods: A total of 270 patients scheduled for elective surgery for cervical spondylosis of spinal cord and nerve root type from August 2012 to January 2016 were enrolled and randomly allocated to the MLS or SOS group by random numbers. Patients were evaluated for difficult airway preoperatively, and Cormack-Lehane laryngoscopy classification was determined during anesthesia induction. Difficult airway was defined as Cormack-Lehane Grades III-IV. Patients were intubated with the randomly assigned intubation device. The success rate, intubation time, required assistance, immediate complications, and postoperative complaints were recorded. Categorical variables were analyzed by Chi-square test, and continuous variables were analyzed by independent samples t-test or rank sum test. Results: The success rate of intubation among normal airways was 100% in both groups. In patients with difficult airway, the success rates in the MLS and SOS groups were 84.2% and 94.1%, respectively (P = 0.605). Intubation with SOS took longer compared with MLS (normal airway: 25.1 +/- 5.8 s vs. 24.5 +/- 5.7 s, P = 0.426; difficult airway: 38.5 +/- 8.5 s vs. 36.1 +/- 8.2 s, P = 0.389). Intubation with SOS required less assistance in patients with difficult airway (5.9% vs. 100%, P < 0.001). The frequency of postoperative sore throat was lower in SOS group versus MLS group in patients with normal airway (22.0% vs. 34.5%, P = 0.034). Conclusions: SOS is a safe and effective airway management device in patients undergoing surgery for cervical spondylosis. Compared with MLS, SOS appears clinically beneficial for intubation, especially in patients with difficult airway.
引用
收藏
页码:297 / 302
页数:6
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