Aysun POSTACI, Müge ÇAKIRCA, Özlem SAÇAN, İsmail AYTAÇ, Bahar SAKIZCI UYAR, Semih BAFİKAN, Mustafa BAYDAR, Iflıl ÖZKOÇAK TURAN

OBEZ HASTALARIN ENTÜBASYONUNDA MCGRATH SERİ 5 VİDEOLARİNGOSKOPİ VE MACİNTOSH LARİNGOSKOPİNİN KARŞILAŞTIRILMASI

Amaç: Obez hastalarda videolaringoskopi kullanımının zor entübasyon yönetiminde etkinliği tartışılmaktadır. Bu çalışmada, obezhastaların entübasyon girişimlerinde McGrath seri 5 Videolaringoskop ile Macintosh Laringoskop kullanımının etkinlik yönündenkarşılaştırılması amaçlandı. Yöntem: Prospektif, randomize, tek kör olarak planlanan bu çalışmaya ASA I-III, 18-65 yaş, VKİ >=30 kg m-2olan 83 obez kadın hastadahil edildi. Hastalar Videolaringoskopi (VL) ve Macintosh laringoskopi (ML) olmak üzere iki gruba ayrıldı. Modifiye mallampati testi(MMT), boyun çevresi, sternomental mesafe, tiromental mesafe (TMM), Modifiye Cormack Lehane (CL), zor entübasyon skalası (ZES),laringoskopi süreleri ve laringoskopi işlemi yapılırken oluşan komplikasyonlar kayıt edildi. Bulgular: Zor entübasyon belirteçleri karşılaştırıldığında MMT, TMM benzerdi. Videolaringoskopi grubunun CL skorları MLgrubuna gore daha düşük bulundu (p=0.022). Zor entübasyon skorları karşılaştırıldığında iki grup arasında fark bulunmadı (p=0.616).Laringoskopi süreleri VL grubunda anlamlı olarak daha uzun bulundu (ML=14.6±4.7s, VL=23.4±9.3s). Her iki grup arasındakomplikasyonlar benzer bulundu. Sonuç: Çalışmamızda videolaringoskopi, zor havayolu yönetimi beklenen obez hastaların entübasyonunda glottik görünümünüiyileştirdi. Ancak tek başına glottisin iyi görüntülenmesi, entübasyon başarısında bir üstünlük sağlamadı. Bu sebeple obez hastalardaentübasyon başarısını da yükseltmeyi amaçlayan cihazların geliştirilebilmesi için ileri çalışmalara gerek vardır

COMPARISON OF THE MCGRATH SERIES 5 VIDEOLARYNGOSCOPE TO THE STANDARD MACINTOSH LARYNGOSCOPE FOR THE INTUBATION OF THE OBESE PATIENTS

Objective: It is considered that evidence is required for effectiveness of videolaryngoscopy in obese patient’s difficult intubationmanagement. We aim to compare the effectiveness of McGrath Series 5 videolaryngoscope to the Macintosh laryngoscope for theintubation of the obese patients. Method: In this randomized, prospective, single-blind study, 84 female patients with ASA I-III, 18-65 age, BMI≥30 kg m-2were included.Patients were divided into two groups as intubated with Videolarinyngoscope (VL) and Macintosh laryngoscope (ML). Modified mallampatiscore (MMS), neck circumference, sternomental and thyromental (TMD) distances, Modified Cormack Lehane grading (CL), intubationdifficulty scale (IDS), laryngoscopy time and complications of laryngoscopy.Results: By comparison with predictors of the difficult intubation, MMS and TMD were similar. Videolaryngoscope significantlydecreased CL grade compared with ML (p=0.022). While comparing in terms of IDS there was no significant difference between groups(p=0.616). Laryngoscopy time was significantly longer in the VL group (ML=14.6±4.7s, VL=23.4±9.3s). There was not significantdifference for complications between groups.Conclusion: This study showed that videolaryngoscopy improves the glottic view of the obese cases when difficult intubation isestimated. However just the improved view of the glottis, could not provide superiority for intubation success. Therefore, further studiesare needed to develop the devices to facilitate intubation in obese patients

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