可视硬质喉镜与Macintosh喉镜在甲状腺手术中应用低剂量肌松药的比较。
Visual rigid laryngoscope versus Macintosh laryngoscope using low-dose relaxants in thyroid surgery.
文献信息
| PMID | 42974453 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Weihuang Qiu |
| 作者单位 | Department of Anesthesiology, Anesthesiology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China. |
| 期刊 | PeerJ |
| SCI 分区 | Q2 |
| IF | 2.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 本研究评估在甲状腺手术中采用低剂量肌松药方案时，Macintosh喉镜与可视硬质喉镜（VRL）用于气管插管的安全性和有效性，为该场景下选择最佳插管工具提供临床证据。
方法： 在这项单中心随机对照试验中，两名经验丰富的麻醉医师对接受择期甲状腺手术并术中神经监测（IONM）的患者使用Macintosh喉镜（Mac组，n=47）或VRL（VRL组，n=45）进行气管插管。主要结局为插管时间。次要结局包括首次插管成功率、围插管期血流动力学变化、按Cormack-Lehane分级评估的喉镜视野以及插管相关并发症。
结果： VRL组插管时间（均值±标准差，33.27±8.36秒）显著短于Mac组（52.19±9.83秒）（P<0.001）。两组插管成功率和心率无差异（P>0.05）。VRL组插管时平均动脉压（MAP）及插管期间MAP升高幅度低于Mac组（P<0.005）。两组在外周血氧饱和度（SpO2）、Cormack-Lehane分级或插管相关并发症方面未观察到统计学显著差异（P>0.05）。
结论： 在采用低剂量肌松药方案以实施IONM的甲状腺手术中，与Macintosh喉镜相比，VRL可显著缩短插管时间并在插管时提供更好的血流动力学稳定性。两种设备在插管成功率、喉镜视野或插管相关并发症方面未观察到显著差异。
英文摘要
OBJECTIVE: This study evaluated the safety and efficacy of the Macintosh laryngoscope versus the visual rigid laryngoscope (VRL) for tracheal intubation under a low-dose muscle relaxant protocol in thyroid surgery, to provide clinical evidence for the selection of optimal intubation tools for this setting.
METHODS: In this single-center, randomized controlled trial, two experienced anesthesiologists performed tracheal intubation using either the Macintosh laryngoscope (Mac group, n = 47) or VRL (VRL group, n = 45) in patients undergoing elective thyroid surgery with Intraoperative neuromonitoring (IONM). The primary outcome was intubation time. Secondary outcomes included first-attempt intubation success rate, hemodynamic changes during the peri-intubation period, laryngoscopic view graded by the Cormack-Lehane classification, and intubation-related complications.
RESULTS: The intubation time was significantly shorter in the VRL group (mean ± SD, 33.27 ± 8.36 s) than in the Mac group (52.19 ± 9.83 s) (P < 0.001). The intubation success rate and heart rates did not differ between groups (P > 0.05). The mean arterial pressure (MAP) at intubation and the amplitude of MAP increase during intubation was lower in Group VRL than in Group Mac (P < 0.005). No statistically significant differences were observed between the two groups in peripheral oxygen saturation (SpO2), Cormack-Lehane classification, or intubation-related complications (P > 0.05).
CONCLUSION: For thyroid surgery using a low-dose muscle relaxant protocol to enable IONM, the VRL provides significantly shorter intubation time and better hemodynamic stability at intubation compared with the Macintosh laryngoscope. No significant differences were observed between the two devices in intubation success rate, laryngoscopic view, or intubation-related complications.