Cooper Richard M, Pacey John A, Bishop Michael J, McCluskey Stuart A
Department of Anesthesia and Pain Management, Toronto General Hospital, 200 Elizabeth Street, 3 EN-421, Toronto, Ontario M5G 2C4, Canada.
Can J Anaesth. 2005 Feb;52(2):191-8. doi: 10.1007/BF03027728.
To evaluate a new videolaryngoscope and assess its ability to provide laryngeal exposure and facilitate intubation.
Five centres, involving 133 operators and a total of 728 consecutive patients, participated in the evaluation of a new video-laryngoscope [GlideScope (GS)]. Many operators had limited or no previous GS experience. We collected information about patient demographics and airway characteristics, Cormack-Lehane (C/L) views and the ease of intubation using the GS. Failure was defined as abandonment of the technique.
Data from six patients were incomplete and were excluded. Excellent (C/L 1) or good (C/L 2) laryngeal exposure was obtained in 92% and 7% of patients respectively. In all 133 patients in whom both GS and direct laryngoscopy (DL) were performed, GS resulted in a comparable or superior view. Among the 35 patients with C/L grade 3 or 4 views by DL, the view improved to a C/L 1 view in 24 and a C/L 2 view in three patients. Intubation with the GS was successful in 96.3% of patients. The majority of the failures occurred despite a good or excellent glottic view.
GS laryngoscopy consistently yielded a comparable or superior glottic view compared with DL despite the limited or lack of prior experience with the device. Successful intubation was generally achieved even when DL was predicted to be moderately or considerably difficult. GS was abandoned in 3.7% of patients. This may reflect the lack of a formal protocol defining failure, limited prior experience or difficulty manipulating the endotracheal tube while viewing a monitor.
评估一种新型视频喉镜，并评估其提供喉部暴露及便于插管的能力。
五个中心，涉及133名操作者和总共728例连续患者，参与了一种新型视频喉镜[GlideScope（GS）]的评估。许多操作者此前对GS的经验有限或没有经验。我们收集了有关患者人口统计学和气道特征、Cormack-Lehane（C/L）分级视野以及使用GS进行插管的难易程度的信息。失败定义为放弃该技术。
6例患者的数据不完整，被排除。分别有92%和7%的患者获得了优（C/L 1级）或良（C/L 2级）的喉部暴露。在所有133例同时进行了GS和直接喉镜检查（DL）的患者中，GS获得的视野相当或更优。在35例经DL评估为C/L 3级或4级视野的患者中，24例患者的视野改善为C/L 1级，3例患者的视野改善为C/L 2级。使用GS插管的成功率为96.3%。尽管声门视野良好或优秀，但大多数失败情况仍有发生。
尽管操作者对该设备的经验有限或缺乏经验，但与DL相比，GS喉镜检查始终能获得相当或更优的声门视野。即使预计DL操作会有中度或较大困难，通常也能成功插管。3.7%的患者放弃了使用GS。这可能反映出缺乏定义失败的正式方案、先前经验有限或在观看监视器时操作气管导管有困难。
