Postoperative sore throat and subglottic injury after McGrath? MAC videolaryngoscopic intubation with versus without a stylet in patients with a high Mallampati score: a randomized controlled trial

摘要

A tracheal tube stylet can be used to assist successful tracheal intubation, especially during videolaryngoscopic intubation because videolaryngoscopes with a Macintosh-type blade such as McGrath? MAC videolaryngoscope have more acute angle than conventional Macintosh laryngoscope. However, the use of a stylet during tracheal intubation can raise concerns about stylet-induced postoperative airway complications, such as sore throat, subglottic injury, and hoarseness. In this study, we compared the incidence of postoperative airway complications after McGrath? MAC videolaryngoscopic intubation with versus without a stylet in patients with a high Mallampati score. In 104 patients with Mallampati score III or IV and who were scheduled for lumbar or thoracic spine surgery, McGrath? MAC videolaryngoscopic intubation was performed either with a stylet (group S, n?=?52) or without a stylet (group N, n?=?52). The primary outcome measure was the incidences of sore throat evaluated at 1 and 24?h postoperatively. Secondary outcome measures were the incidences of subglottic injury and postoperative hoarseness. The incidence of CL grade III in group S and N was 3.8 and 5.8%, respectively. No patient showed CL grade IV. The incidences of sore throat at 1 (26.9 vs 19.2%, P?=?0.485) and 24?h (17.3 vs 13.5%, P?=?0.786, respectively) postoperatively were not significantly different between the group S and N. However, the incidence of subglottic injury was significantly higher in the group S, compared with the group N (65.4 vs 42.3%, P?=?0.030). The incidence of postoperative hoarseness did not differ significantly between the two groups. The use of a stylet during McGrath? MAC videolaryngoscopic intubation did not have a significant impact on the incidence of postoperative sore throat in patients with a high Mallampati score. Avoiding the use of a stylet during intubation with McGrath? MAC videolaryngoscope may reduce the incidence of subglottic injury in such patients. Clinical Research Information Service (identifier: KCT0002427 , date of registration: June 12, 2017).