新型Viewmax喉镜在模拟困难气道中的评估

Evaluation of the new Viewmax laryngoscope in a simulated difficult airway.

作者信息

Leung Y Y, Hung C T, Tan S T

机构信息

Department of Anaesthesiology, Queen Elizabeth Hospital, Kowloon, Hong Kong.

出版信息

Acta Anaesthesiol Scand. 2006 May;50(5):562-7. doi: 10.1111/j.1399-6576.2006.001006.x.

DOI:10.1111/j.1399-6576.2006.001006.x

PMID:16643225

Abstract

BACKGROUND

In this study, we evaluated the learning curve and performance of the Viewmax laryngoscope during simulated difficult laryngoscopy in an intubation manikin (Laerdal Airway Management Trainer).

METHODS

To determine the learning curve, 25 anaesthesiologists without previous experience with the Viewmax laryngoscope performed 10 successive intubations in an intubation manikin with a normal airway. Time to intubation and failed intubation attempts were recorded. Another manikin was modified to enable comparison of the Viewmax laryngoscope with Macintosh and McCoy laryngoscopes. The time to intubation, number of failed intubation attempts, modified Cormack and Lehane (MCL) laryngeal view grading, percentage of glottic opening (POGO score), use of gum elastic bougie and subjective rating of degree of difficulty were recorded.

RESULTS

The learning curve for the Viewmax laryngoscope showed a progressive decrease in time to successful intubation and reached a plateau at the sixth attempt. In simulated difficult laryngoscopy, the Viewmax laryngoscope demonstrated significantly better laryngeal view than the Macintosh and McCoy laryngoscopes in terms of MCL grading (Macintosh, P = 0.01; McCoy, P < 0.01) and POGO score (Macintosh, P < 0.01; McCoy, P < 0.01). The time required for intubation in simulated difficult laryngoscopy for the Viewmax laryngoscope was significantly longer than that for the Macintosh (P = 0.02) and McCoy (P < 0.01) laryngoscopes. There was no significant difference in the degree of difficulty, number of failed intubations and use of gum elastic bougie.

CONCLUSION

When compared with the Macintosh and McCoy laryngoscopes in a manikin, the Viewmax laryngoscope appears to improve the view of the larynx but requires a longer time for tracheal intubation.

摘要

背景

在本研究中，我们评估了Viewmax喉镜在插管人体模型（Laerdal气道管理训练器）模拟困难喉镜检查过程中的学习曲线和性能。

方法

为确定学习曲线，25名此前无使用Viewmax喉镜经验的麻醉医生在气道正常的插管人体模型上连续进行10次插管。记录插管时间和插管失败次数。对另一个人体模型进行改造，以便将Viewmax喉镜与Macintosh喉镜和McCoy喉镜进行比较。记录插管时间、插管失败次数、改良的Cormack和Lehane（MCL）喉镜视野分级、声门开口百分比（POGO评分）、弹性橡胶探条的使用情况以及主观难度评分。

结果

Viewmax喉镜的学习曲线显示成功插管时间逐渐减少，并在第六次尝试时达到平稳状态。在模拟困难喉镜检查中，就MCL分级（Macintosh喉镜，P = 0.01；McCoy喉镜，P < 0.01）和POGO评分（Macintosh喉镜，P < 0.01；McCoy喉镜，P < 0.01）而言，Viewmax喉镜的喉镜视野明显优于Macintosh喉镜和McCoy喉镜。在模拟困难喉镜检查中，Viewmax喉镜的插管所需时间明显长于Macintosh喉镜（P = 0.02）和McCoy喉镜（P < 0.01）。在难度程度、插管失败次数和弹性橡胶探条的使用方面，差异无统计学意义。