Department of Anesthesiology, American University of Beirut Medical Center, Beirut, Lebanon.
Anaesthesia. 2010 Jul;65(7):674-8. doi: 10.1111/j.1365-2044.2010.06335.x. Epub 2010 May 17.
Tracheal intubation using direct laryngoscopy has a high failure rate when performed by untrained medical personnel. This study compares tracheal intubation following direct laryngoscopy by inexperienced medical students when initially trained by using either the GlideScope, a video assisted laryngoscope, or a rigid (Macintosh) laryngoscope. Forty-two medical students with no previous experience in tracheal intubation were randomly divided into two equal groups to receive training with the GlideScope or with direct laryngoscopy. Subsequently, each medical student performed three consecutive intubations on patients with normal airways that were observed by a anaesthetist who was blinded to the training method. The rates of successful intubation were significantly higher in the Glidescope group after the first (48%), second (62%), and third (81%) intubations compared with the Macintosh group (14%, 14% and 33%; p = 0.043, 0.004 and 0.004, respectively). The mean (SD) times for the first, second, and third successful tracheal intubations were significantly shorter in the Glidescope group (59.3 (4.4) s, 56.6 (7.1) s and 50.1 (4.0) s) than the Macintosh group (70.7 (7.5) s, 73.7 (7.3) s and 67.6 (2.0) s; p = 0.006, 0.003 and 0.0001, respectively). Training with a video-assisted device such as the GlideScope improves the success rate and time for tracheal intubation in patients with normal airways when this is performed by inexperienced individuals following a short training programme.
在未经训练的医务人员进行时,直接喉镜下的气管插管失败率很高。本研究比较了经验不足的医学生在最初接受 GlideScope(一种视频辅助喉镜)或刚性(Macintosh)喉镜培训后进行直接喉镜下气管插管的情况。42 名以前没有气管插管经验的医学生被随机分为两组,分别接受 GlideScope 或直接喉镜培训。随后,每位医学生在气道正常的患者身上进行了三次连续的插管,由一位麻醉师进行观察,麻醉师对培训方法一无所知。GlideScope 组在第一次(48%)、第二次(62%)和第三次(81%)插管中的成功率明显高于 Macintosh 组(14%、14%和 33%;p=0.043、0.004 和 0.004)。GlideScope 组第一次、第二次和第三次成功气管插管的平均(SD)时间明显短于 Macintosh 组(59.3(4.4)s、56.6(7.1)s 和 50.1(4.0)s)(70.7(7.5)s、73.7(7.3)s 和 67.6(2.0)s;p=0.006、0.003 和 0.0001)。使用 GlideScope 等视频辅助设备进行培训,可以提高气道正常患者的气管插管成功率和时间,即使是经验不足的人员,在接受短期培训后也可以进行。