视频喉镜与手术室内内管管道直接喉镜:一个集群随机临床试验
Kurt Ruetzler1,2, Sergio Bustamante3, Marc T Schmidt1
1Outcomes Research Consortium, Department of Anesthesiology, Cleveland Clinic, Cleveland, Ohio.
JAMA
|March 18, 2024
概括
与直接喉镜相比,超角视频喉镜显著减少了手术患者内管试验的数量. 这种方法在手术期间更适合呼吸道管理.
科学领域:
- 麻醉学
- 气道管理
- 外科手术
背景情况:
- 直接喉腔镜是手术室内输内管道的标准.
- 视频喉腔镜可以改善呼吸道的可视化,但它对手术环境中的输液管试验的影响尚未得到充分证实.
研究的目的:
- 在成年手术患者中,使用视频喉腔镜与直接喉腔镜试验的数量进行比较.
主要方法:
- 一个集群随机交叉试验,涉及接受心脏,胸部或血管手术的成年患者,需要内腔管道输入.
- 操作室每周随机选择使用超角视频喉腔镜或直接喉腔镜进行初始输管试验.
- 针对8429次手术的数据进行了治疗意向分析.
主要成果:
- 视频喉腔镜检查所需的输内管试验较少 (1.7%),而不是直接喉腔镜检查 (7.6%).
- 视频喉腔镜 (0. 27%) 与直接喉腔镜 (4. 0%) 的输入失败率明显较低.
- 这两种方法的呼吸道和牙损伤率相似.
结论:
- 超角视频喉腔镜可减少手术患者内管试验和内管失败的次数.
- 在这种患者群体中,视频喉腔镜似乎是一种更有效的输内管道输入方法.
- 进一步的研究可能会支持视频喉腔镜作为手术呼吸道管理的首选方法.
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