Hodzovic I, Janakiraman C, Sudhir G, Goodwin N, Wilkes A R, Latto I P
Department of Anaesthetics and Intensive Care Medicine, Cardiff University, Cardiff, UK.
Anaesthesia. 2009 Oct;64(10):1066-71. doi: 10.1111/j.1365-2044.2009.06030.x.
In a randomised crossover study, we compared times and success rates for tracheal placement of a fibrescope and railroading of a tracheal tube through the classic laryngeal mask airway by anaesthetists with limited experience in fibreoptic intubation (trainees) and those who were experts. Thirty-two patients, 32 trainees and three experts took part. The median (IQR [range]) times to fibrescope placement for trainees and experts were 21 (18-30 [12-58]) s and 17 (14-24 [9-55]) s, respectively (95% CI for the difference 2-8 s; p = 0.023). There were no significant differences between trainees and experts in the times to placement of the laryngeal mask airway (41 (33-47 [31-105]) s and 36 (33-43 [30-52]) s, respectively; p = 0.24), railroading times (43 (40-58 [33-87]) s and 44 (38-57 [31-83]) s, respectively; p = 0.96) and total intubation time (114 (97-127 [80-213]) s and 95 (89-116 [74-139]) s, respectively; p = 0.13). There was no significant difference in the number of attempts needed for successful placement of the fibrescope (p = 0.12) and railroading the tracheal tube (p = 0.22). The differences between experts and trainees when using fibrescope assisted intubation via the classic laryngeal mask airway were not clinically important.
在一项随机交叉研究中，我们比较了经验有限的麻醉医生（实习生）和专家通过经典喉罩气道进行纤维支气管镜气管置入及气管导管导入的时间和成功率。32例患者、32名实习生和3名专家参与了研究。实习生和专家纤维支气管镜置入的中位时间（IQR[范围]）分别为21（18 - 30[12 - 58]）秒和17（14 - 24[9 - 55]）秒（差异的95%CI为2 - 8秒；p = 0.023）。实习生和专家在喉罩气道置入时间（分别为41（33 - 47[31 - 105]）秒和36（33 - 43[30 - 52]）秒；p = 0.24）、导入时间（分别为43（40 - 58[33 - 87]）秒和44（38 - 57[31 - 83]）秒；p = 0.96）及总插管时间（分别为114（97 - 127[80 - 213]）秒和95（89 - 116[74 - 139]）秒；p = 0.13）方面均无显著差异。纤维支气管镜成功置入所需尝试次数（p = 0.12）和气管导管导入所需尝试次数（p = 0.22）也无显著差异。通过经典喉罩气道使用纤维支气管镜辅助插管时，专家和实习生之间的差异在临床上并不重要。
