Comparison of the Clinical Use ofMacintosh and Miller Laryngoscopes for Orotracheal Intubation by Second-Month Nurse Students in Anesthesiology
ลัดดา เพิ่มผลประเสริฐ, Neunghathai Kunanont, พงษ์ธารา วิจิตเวชไพศาล, Thantima Vallisut, Ungkab Prakanrattana, สมชาย อมรโยธิน*
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. E-mail: [email protected]
บทคัดย่อ
Aim: The aim of this study is to compare the clinical feasibility of Macintosh and Miller laryngoscopes for tracheal intubation in non-experienced users in anesthetized patients. Patients and Methods: 119 patients were randomized into the Macintosh group (59) and theMiller group (60). The primary outcome variable was successful tracheal intubation. The secondary outcome variables were number of insertion attempt, intubation time needed, total time to intubation, hemodynamic change and complications.Results: All patients were successfully intubated using the Macintosh, whereas 13 patients (21.6%) were failed with the Miller (P < .001). The Macintosh significantly reduced the mean total time to intubation (P < .001). There were significant differences in the mean blood pressure at 2 minutes after laryngoscope insertion, immediately, and 2 minutes after tracheal intubation and in the mean heart rate at the laryngoscope insertion, immediately, and at 2 minutes after tracheal intubation between the two groups. Overall complications in both were not significantly different. Conclusion: Orotracheal intubation using the Macintosh is an effective and safe technique in non-experienced hands with significantly increased success rate as well as decreased mean total time to intubation as compare to the Miller. However, these intubations only apply to selected patients deemed to have normal airways.
ที่มา
Anesthesiology Research and Practice ปี 2553, August ปีที่: 2010 ฉบับที่ หน้า 1-5