北海道大学病院での最近6年（2016-2021年）の高度気管挿管困難症の現況

Survey of Patients Presented with Severely Difficult intubation in Hokkaido University Hospital（2016-2021）

要旨

　当院でビデオ喉頭鏡導入後の6年で主観的挿管困難度が “難”，かつ気管挿管操作に20分以上要した高度気管挿管困難症例を後ろ向きに検討した。高度気管挿管困難症例は25,401回の気道確保のうち15回（0.06％）で，ビデオ喉頭鏡の導入前の調査での高度気管挿管困難症例の割合（0.3％）と比較して有意に減少した（P値＜0.001）。ビデオ喉頭鏡は高度挿管困難症の低減に貢献していると考えられる。

　Background：Video laryngoscopy has been reported to be more valuable than direct laryngoscopy in cases of limited neck retroversion and obesity. However, whether video laryngoscopy reduces the incidence of severe intubation difficulties has yet to be thoroughly investigated.

　Methods：A study was made on patients whose airway was secured by anesthesiologist in the six years following the introduction of the McGRATH MAC^TM in our operating room. Patients were defined as having severe intubation difficulties, rated as “difficult” and requiring more than 20 minutes. The primary endpoint was the incidence of significant intubation difficulty.

　Results：Of the 25401 patients included in the study, 15 had severe intubation difficulties, representing 0.06％ of the total, a significant decrease compared to 0.3％ before the introduction of the video laryngoscope.

　Conclusions：Video laryngoscopy contributes to the reduction of severe intubation difficulties.