在麻醉和瘫痪患者中，通过不同尺寸的Airtraq喉镜比较标准聚氯乙烯气管导管和直管强化气管导管用于气管插管的效果：一项随机前瞻性研究。

Comparison of standard polyvinyl chloride tracheal tubes and straight reinforced tracheal tubes for tracheal intubation through different sizes of the Airtraq laryngoscope in anesthetized and paralyzed patients: a randomized prospective study.

作者信息

Dimitriou Vassilios K, Zogogiannis Ioannis D, Douma Amalia K, Pentilas Nikolaos D, Liotiri Despoina G, Wachtel Mitchell S, Karakitsos Dimitrios

机构信息

Department of Anesthesia, G Gennimatas General Hospital of Athens, Athens, Greece.

出版信息

Anesthesiology. 2009 Dec;111(6):1265-70. doi: 10.1097/ALN.0b013e3181c0ad5b.

DOI:10.1097/ALN.0b013e3181c0ad5b

PMID:19934870

Abstract

BACKGROUND

The authors compared the intubation success rate of straight reinforced tracheal tubes emerging from the Airtraq laryngoscope (Prodol Meditec S.A., Vizcaya, Spain) with standard preformed polyvinyl chloride tracheal tubes in anesthetized patients.

METHODS

The authors randomly allocated 347 adult patients to be intubated with standard polyvinyl chloride tracheal tubes, standard straight wire-reinforced tracheal tubes, or silicone straight wire-reinforced tubes, through either the larger or the smaller adult laryngoscope sizes. The possible influence of laryngoscope size, tube size, and tube type on intubation failure was examined.

RESULTS

Success rates were 100% for polyvinyl chloride tracheal tubes, 78.5% for standard wire-reinforced tracheal tubes, and 75.4% for silicone wire-reinforced tubes (P < 0.01). Compared with the former, patients in the straight standard and silicone wire-reinforced tube groups required more optimization maneuvers (4.1% vs. 42.1%; P < 0.01) and more attempts at successful intubation (0% vs. 7.3%; P < 0.01). The angle created by the tube emerging from the Airtraq guiding channel was inversely correlated to the ratio of the endotracheal tube OD to the width of the channel in the standard and silicone wire-reinforced tube groups (r = -0.95 and r = -0.82, respectively; P < 0.01). Finally, a decrease in 0.1 of the above ratio was associated with a 3.1 (95% confidence interval, 1.9-5.2; P < 0.01) times increase in the odds ratio of intubation failure.

CONCLUSIONS

Standard polyvinyl chloride tracheal tubes were found to be superior compared with standard and silicone straight wire-reinforced tubes for intubation through the Airtraq laryngoscope. In the latter groups, a decrease of the ratio of their OD to the width of the Airtraq guiding channel resulted in increased intubation failure.

摘要

背景

作者比较了在麻醉患者中，使用Airtraq喉镜（西班牙比斯开省Prodol Meditec S.A.公司生产）时直管型加强气管导管与标准预制聚氯乙烯气管导管的插管成功率。

方法

作者将347例成年患者随机分为三组，分别使用标准聚氯乙烯气管导管、标准直管型钢丝加强气管导管或硅胶直管型钢丝加强气管导管，通过成人尺寸较大或较小的喉镜进行插管。研究了喉镜尺寸、导管尺寸和导管类型对插管失败的可能影响。

结果

聚氯乙烯气管导管的成功率为100%，标准钢丝加强气管导管的成功率为78.5%，硅胶钢丝加强气管导管的成功率为75.4%（P<0.01）。与前者相比，直管型标准和硅胶钢丝加强导管组的患者需要更多的优化操作（4.1%对42.1%；P<0.01）和更多的成功插管尝试（0%对7.3%；P<0.01）。在标准和硅胶钢丝加强导管组中，从Airtraq引导通道伸出的导管形成的角度与气管导管外径与通道宽度的比值呈负相关（分别为r=-0.95和r=-0.82；P<0.01）。最后，上述比值每降低0.1，插管失败的比值比增加3.1倍（95%置信区间，1.9-5.2；P<0.01）。