Powell L, Andrzejowski J, Taylor R, Turnbull D
Department of Anaesthesia, Sheffield Teaching Hospitals NHS Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK.
Br J Anaesth. 2009 Nov;103(5):755-60. doi: 10.1093/bja/aep232. Epub 2009 Aug 26.
Novel laryngoscopes may demonstrate advantages over the traditional Macintosh laryngoscope for difficult airways. Our study compared Glidescope laryngoscope, Bonfils fibrescope, and CTrach intubating laryngeal mask airway with the Macintosh laryngoscope in a simulated normal and difficult airway, considering the additional effect of previous intubation experience.
Twenty-two non-anaesthetists, 21 trainees, and 20 consultant anaesthetists attempted tracheal intubation of a Laerdal SimMan manikin, comparing a normal with a difficult airway scenario for each intubation device. The time taken to view the vocal cords and time to intubate were recorded. Also success rate and ease of use for each device were scored, alongside scope preference for each scenario.
Time to intubate was significantly shorter with the Macintosh compared with all three novel devices. All the devices had a high first-attempt success rate, but the Glidescope had a 100% first time successful intubation for all participants in both a normal and a difficult airway. Non-anaesthetists took significantly longer time to intubate compared with consultant anaesthetists, but there was no difference between trainee and consultant anaesthetists. Higher proportions of participants found the Glidescope easy to use, compared with other devices. For the normal airway, the Macintosh was the preferred device, but for the difficult airway, the Glidescope was favoured.
In this study, the Macintosh laryngoscope outperformed the other devices. However, the Glidescope was considered easy to use regardless of previous experience and was the preferred device for the simulated difficult airway.
对于困难气道，新型喉镜可能比传统的麦金托什喉镜具有优势。我们的研究在模拟的正常气道和困难气道中，比较了Glidescope喉镜、邦菲尔斯纤维喉镜、CTrach气管插管喉罩气道与麦金托什喉镜，并考虑了既往插管经验的额外影响。
22名非麻醉医师、21名实习医师和20名麻醉科顾问医师尝试对Laerdal SimMan人体模型进行气管插管，针对每种插管设备比较正常气道和困难气道情况。记录观察声带的时间和插管时间。同时对每种设备的成功率和易用性进行评分，并记录每种情况下对喉镜的偏好。
与所有三种新型设备相比，使用麦金托什喉镜插管的时间显著更短。所有设备首次尝试成功率都很高，但Glidescope喉镜在正常气道和困难气道中所有参与者的首次插管成功率均为100%。非麻醉医师插管时间显著长于麻醉科顾问医师，但实习医师和麻醉科顾问医师之间没有差异。与其他设备相比，更高比例的参与者认为Glidescope喉镜易于使用。对于正常气道，麦金托什喉镜是首选设备，但对于困难气道，Glidescope喉镜更受青睐。
在本研究中，麦金托什喉镜的表现优于其他设备。然而，无论既往经验如何，Glidescope喉镜都被认为易于使用，并且是模拟困难气道的首选设备。
