Abstract：
BACKGROUND: Pediatric airway management requires careful clinical evaluation and experienced execution due to anatomical, physiological, and developmental considerations. Video laryngoscopy in pediatric airways is a developing area of research, with recent data suggesting that video laryngoscopes are better than standard Macintosh blades. Specifically, there is a paucity of literature on the advantages of the C-MAC D-blade compared to the McCoy direct laryngoscope.
METHODS: After Ethics Committee approval, 70 American Society of Anesthesiologists physical status 1 and 2 children aged 4-12 years scheduled for elective surgery under general anesthesia were recruited. Patients were randomly allocated to intubation using a C-MAC video laryngoscope size 2 D-blade (Group 1) and a McCoy laryngoscope size 2 blade (Group 2). The Intubation Difficulty Scale (IDS) for ease of intubation was the primary outcome, while Cormack-Lehane grades, duration of laryngoscopy and intubation, hemodynamic responses, and incidence of any airway complications were secondary outcomes.
RESULTS: Both groups were comparable in terms of patient characteristics. The median (IQR) Intubation Difficulty Scale (IDS) score was better but was statistically nonsignificant with C-MAC (0 [0-0] vs. 0 [0-2], p = .055). The glottic views were superior (CL grade I in 32/35 vs. 23/35, p = .002), and the time to best glottic view (6 s [5-7] vs. 8.0 s [6-10], p = .006) was lesser in the C-MAC D-blade group while the total duration of intubation was comparable (20 s [16-22] vs. 18 s [15-22], p = .374). All the patients could be successfully intubated on the first attempt. None of the patients had any complications.
CONCLUSIONS: The C-MAC video laryngoscope size 2 D-blade provided faster and better glottic visualization but similar intubation difficulty compared to McCoy size 2 laryngoscope in children. The shorter time to achieve glottic view demonstrated with the C-MAC failed to translate into a shorter total duration of intubation when compared to the McCoy laryngoscope attributable to a pronounced curvature of the D-blade.
METHODS: After Ethics Committee approval, 70 American Society of Anesthesiologists physical status 1 and 2 children aged 4-12 years scheduled for elective surgery under general anesthesia were recruited. Patients were randomly allocated to intubation using a C-MAC video laryngoscope size 2 D-blade (Group 1) and a McCoy laryngoscope size 2 blade (Group 2). The Intubation Difficulty Scale (IDS) for ease of intubation was the primary outcome, while Cormack-Lehane grades, duration of laryngoscopy and intubation, hemodynamic responses, and incidence of any airway complications were secondary outcomes.
RESULTS: Both groups were comparable in terms of patient characteristics. The median (IQR) Intubation Difficulty Scale (IDS) score was better but was statistically nonsignificant with C-MAC (0 [0-0] vs. 0 [0-2], p = .055). The glottic views were superior (CL grade I in 32/35 vs. 23/35, p = .002), and the time to best glottic view (6 s [5-7] vs. 8.0 s [6-10], p = .006) was lesser in the C-MAC D-blade group while the total duration of intubation was comparable (20 s [16-22] vs. 18 s [15-22], p = .374). All the patients could be successfully intubated on the first attempt. None of the patients had any complications.
CONCLUSIONS: The C-MAC video laryngoscope size 2 D-blade provided faster and better glottic visualization but similar intubation difficulty compared to McCoy size 2 laryngoscope in children. The shorter time to achieve glottic view demonstrated with the C-MAC failed to translate into a shorter total duration of intubation when compared to the McCoy laryngoscope attributable to a pronounced curvature of the D-blade.
摘要：
背景：儿科气道管理需要仔细的临床评估和有经验的执行，生理,和发展考虑。小儿气道的视频喉镜检查是一个发展中的研究领域，最近的数据表明视频喉镜比标准的Macintosh刀片更好。具体来说,与McCoy直接喉镜相比，关于C-MACD刀片的优势的文献很少。
方法：伦理委员会批准后，招募了70名美国麻醉医师协会的身体状况1和2名4-12岁的儿童，这些儿童计划在全身麻醉下进行择期手术。使用C-MAC视频喉镜尺寸2D刀片（第1组）和McCoy喉镜尺寸2刀片（第2组）将患者随机分配到插管。插管困难量表（IDS）是插管的主要结果，而Cormack-Lehane成绩,喉镜和插管的持续时间，血液动力学反应,和任何气道并发症的发生率是次要结局.
结果：两组在患者特征方面具有可比性。中位（IQR）插管困难量表（IDS）评分较好，但与C-MAC（0[0-0]vs.0[0-2],p=.055）。声门视图较好（CLI级在32/35与23/35，p=.002），以及达到最佳声门视图的时间(6s[5-7]vs.8.0s[6-10]，p=.006）在C-MACD刀片组中较小，而插管的总持续时间相当（20s[16-22]与18s[15-22]，p=.374）。所有患者都可以在第一次尝试时成功插管。所有患者均未出现任何并发症。
结论：在儿童中，与McCoy2号喉镜相比，C-MAC2号视频喉镜提供了更快更好的声门可视化，但插管难度相似。与McCoy喉镜相比，C-MAC显示的较短的声门视图时间未能转化为较短的插管总持续时间，这归因于D刀片的明显弯曲。
方法：伦理委员会批准后，招募了70名美国麻醉医师协会的身体状况1和2名4-12岁的儿童，这些儿童计划在全身麻醉下进行择期手术。使用C-MAC视频喉镜尺寸2D刀片（第1组）和McCoy喉镜尺寸2刀片（第2组）将患者随机分配到插管。插管困难量表（IDS）是插管的主要结果，而Cormack-Lehane成绩,喉镜和插管的持续时间，血液动力学反应,和任何气道并发症的发生率是次要结局.
结果：两组在患者特征方面具有可比性。中位（IQR）插管困难量表（IDS）评分较好，但与C-MAC（0[0-0]vs.0[0-2],p=.055）。声门视图较好（CLI级在32/35与23/35，p=.002），以及达到最佳声门视图的时间(6s[5-7]vs.8.0s[6-10]，p=.006）在C-MACD刀片组中较小，而插管的总持续时间相当（20s[16-22]与18s[15-22]，p=.374）。所有患者都可以在第一次尝试时成功插管。所有患者均未出现任何并发症。
结论：在儿童中，与McCoy2号喉镜相比，C-MAC2号视频喉镜提供了更快更好的声门可视化，但插管难度相似。与McCoy喉镜相比，C-MAC显示的较短的声门视图时间未能转化为较短的插管总持续时间，这归因于D刀片的明显弯曲。
