Savoldelli Georges L, Schiffer Eduardo, Abegg Christoph, Baeriswyl Vincent, Clergue François, Waeber Jean-Luc
Department of Anaesthesiology, Pharmacology and Intensive Care, Geneva University Hospitals, Switzerland.
Eur J Anaesthesiol. 2009 Jul;26(7):554-8. doi: 10.1097/eja.0b013e3283269ff4.
Several video and optical laryngoscopes have been developed but few have been compared in terms of their learning curves and efficacy. Using a manikin with normal airways we compared the Glidescope, the McGrath, the Airtraq and the Macintosh laryngoscopes.
Sixty anaesthetists (20 staff, 20 residents and 20 nurses) participated in the study. All subjects were novice with the new devices. They intubated a Laerdal SimMan manikin (with normal airway) five times in a row with all laryngoscopes. The sequence of use of the devices was randomized. Before using a device, a presentation and a demonstration were provided. Outcome measures were: duration of intubation attempt, modified Cormack grades, dental trauma and difficulty of use.
The Airtraq had the most favourable learning curve and mirrored the Macintosh after two intubation attempts. The Glidescope and McGrath had steep learning curves but, after five attempts, differences persisted when compared with the Macintosh and Airtraq. Time taken to visualize the glottis was similar but time taken to position the endotracheal tube was shorter for the Airtraq when compared with the Glidescope and McGrath. Indirect laryngoscopes seemed to have advantages over the Macintosh blade in terms of laryngeal exposure and potential dental trauma.
In a 'normal airway' model, intubation skills with the new devices appeared to be rapidly mastered. The three indirect laryngoscopes provided a better glottic exposure than the Macintosh. The Airtraq displayed the most favourable learning curve, probably reflecting differences in the techniques of endotracheal tube placement: guiding channel versus steering technique.
已经研发出了多种视频喉镜和光学喉镜，但很少有产品在学习曲线和有效性方面进行比较。我们使用具有正常气道的人体模型，对Glidescope喉镜、麦格拉斯喉镜、Airtraq喉镜和麦金托什喉镜进行了比较。
60名麻醉医生（20名工作人员、20名住院医生和20名护士）参与了这项研究。所有受试者对这些新设备均不熟悉。他们使用所有喉镜对Laerdal SimMan人体模型（具有正常气道）连续进行5次插管操作。设备的使用顺序是随机的。在使用设备之前，进行了讲解和演示。观察指标包括：插管尝试时间、改良的科马克分级、牙齿损伤和使用难度。
Airtraq喉镜具有最有利的学习曲线，在两次插管尝试后与麦金托什喉镜相当。Glidescope喉镜和麦格拉斯喉镜的学习曲线较陡，但在5次尝试后，与麦金托什喉镜和Airtraq喉镜相比仍存在差异。暴露声门的时间相似，但与Glidescope喉镜和麦格拉斯喉镜相比，Airtraq喉镜放置气管导管的时间更短。间接喉镜在暴露喉部和潜在牙齿损伤方面似乎比麦金托什喉镜叶片更具优势。
在“正常气道”模型中，使用这些新设备的插管技能似乎能很快掌握。三种间接喉镜比麦金托什喉镜能更好地暴露声门。Airtraq喉镜显示出最有利的学习曲线，这可能反映了气管导管放置技术的差异：引导通道技术与操纵技术。
