C-MAC Miller 1号镜片置于会厌谷与直接挑起会厌对2岁以下儿童声门显露及插管性能的影响：一项前瞻性随机对照试验
The Effect of C-MAC Miller 1 Blade Placement in the Vallecula Versus Direct Epiglottic Elevation on Glottic Visualization and Intubation Performance in Children Under 2 Years of Age: A Prospective Randomized Controlled Trial.
文献信息
| PMID | 42881945 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Ahmet Kenç |
| 作者单位 | Department of Anesthesiology and Reanimation, Battalgazi State Hospital, Malatya 44210, Turkey. |
| 期刊 | Journal of clinical medicine |
| SCI 分区 | Q1 |
| IF | 3.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景/目的： 本研究旨在比较在2岁以下儿童中使用C-MAC视频喉镜1号Miller镜片行喉镜显露时，镜片尖端置于会厌谷与直接挑起会厌两种方式对声门显露及插管性能的影响。方法：这项前瞻性随机对照试验纳入127例ASA身体状况I-II级、年龄小于2岁、接受择期手术的儿童。参与者被随机分配至V组（会厌谷置入；n=62）或E组（直接挑起会厌；n=65）。麻醉诱导使用芬太尼、硫喷妥钠、七氟烷和罗库溴铵。记录声门开放百分比（POGO）评分、Cormack-Lehane分级、插管困难评分（IDS）、视觉模拟量表（VAS）评分、喉镜显露及插管时间、插管尝试次数、优化操作及并发症。结果：E组POGO评分（中位数[IQR]，96[92-100]）显著高于V组（95[88-100]；p=0.032）。E组Cormack-Lehane分级显著优于V组（p=0.042）。V组喉镜显露时间（5.61±1.15秒）显著短于E组（6.95±1.80秒；p=0.001）。V组插管时间（23.16±4.44秒）也显著短于E组（26.60±4.73秒；p=0.001）。V组VAS评分（9.48±1.09）显著高于E组（9.02±1.09；p=0.018）。结论：在2岁以下儿童中，使用C-MAC视频喉镜1号Miller镜片直接挑起会厌可改善声门显露，而会厌谷置入则与更短的喉镜显露和插管时间相关。两种技术的选择可能取决于临床优先事项；当优先考虑缩短插管时间时，可考虑会厌谷置入，但该假设需要在更高风险人群中开展前瞻性评估。
英文摘要
Background/Objectives: This study aimed to compare glottic visualization and intubation performance during laryngoscopy with the C-MAC video laryngoscope size 1 Miller blade using direct epiglottic elevation versus vallecular placement of the blade tip in children younger than 2 years of age. Methods: This prospective, randomized controlled trial enrolled 127 ASA physical status I-II children younger than 2 years undergoing elective surgery. Participants were randomly allocated to Group V (vallecular placement; n = 62) or Group E (direct epiglottic elevation; n = 65). Anesthesia was induced with fentanyl, thiopental, sevoflurane, and rocuronium. The Percentage of Glottic Opening (POGO) score, Cormack-Lehane grade, Intubation Difficulty Score (IDS), Visual Analogue Scale (VAS) score, laryngoscopy and intubation times, intubation attempts, optimization maneuvers, and complications were recorded. Results: The POGO score was significantly higher in Group E (median [IQR], 96 [92-100]) than in Group V (95 [88-100]; p = 0.032). Cormack-Lehane grades were significantly better in Group E than in Group V (p = 0.042). Laryngoscopy time was significantly shorter in Group V (5.61 ± 1.15 s) than in Group E (6.95 ± 1.80 s; p = 0.001). Intubation time was also significantly shorter in Group V (23.16 ± 4.44 s) than in Group E (26.60 ± 4.73 s; p = 0.001). VAS scores were significantly higher in Group V (9.48 ± 1.09) than in Group E (9.02 ± 1.09; p = 0.018). Conclusions: Direct epiglottic elevation with the C-MAC video laryngoscope size 1 Miller blade improved glottic visualization, whereas vallecular placement was associated with shorter laryngoscopy and intubation times in children younger than 2 years. The choice between the two techniques may depend on clinical priorities; vallecular placement may be considered when minimizing intubation time is a priority, although this hypothesis requires prospective evaluation in higher-risk populations.