Department of Anesthesiology and Department of Biostatistics, University of Rochester School of Medicine & Dentistry, Rochester, NY 14642, USA.
J Clin Anesth. 2010 Aug;22(5):352-9. doi: 10.1016/j.jclinane.2009.10.008.
To compare the success of orotracheal intubation in 62 seconds or less using the GlideScope video laryngoscope (GVL) and a 60 degrees or 90 degrees angled stylet with reverse loading of the endotracheal tube (ETT).
Prospective, randomized study.
Operating room of a university hospital.
120 ASA physical status I, II, and III adult patients undergoing elective surgery requiring general anesthesia with orotracheal intubation.
Patients were randomly allocated to two groups (n = 60 each); both groups received general anesthesia and neuromuscular relaxation. A conventional ETT was styleted and then bent from its straight configuration just above the cuff, either at 60 degrees or 90 degrees against its concave natural curve (reverse loading). Four attending anesthesiologists, who were blinded as to stylet assignment (the 60 degrees or 90 degrees group), intubated the tracheas of all patients with the GVL using either the primary or secondary stylet.
The primary outcome was success of orotracheal intubation in 62 seconds or less. The secondary outcome was actual time to intubation (TTI).
The odds ratio (OR) for intubation success was higher in the 90 degrees group than the 60 degrees group (OR = 10.41; P < 0.03), as evidenced by 59 of 60 patients whose tracheas were intubated successfully within 62 seconds, compared with 51 of 60 patients in the 60 degrees group. Seven of the 9 failures were due to inability of the 60 degrees stylet to reach the glottic opening. The three remaining failures were associated with TTI of more than 62 seconds.
The 90 degrees angled malleable stylet with reverse loading of the ETT provided more reliable ETT delivery to the glottic opening and had a higher success rate than the 60 degrees stylet.
比较使用 GlideScope 视频喉镜（GVL）和 60 度或 90 度弯曲管芯并反向装载气管内导管（ETT）在 62 秒或更短时间内成功进行经口气管插管。
前瞻性、随机研究。
一家大学医院的手术室。
120 名 ASA 身体状况 I、II 和 III 级的成年患者，行全身麻醉下择期手术，需经口气管插管。
患者被随机分配到两组（每组 60 例）；两组均接受全身麻醉和神经肌肉松弛。将常规 ETT 进行管芯化，然后使其从其在套囊上方的直形配置弯曲，要么以 60 度要么以 90 度与凹面自然曲线相对（反向装载）。四名麻醉科主治医生，他们对管芯的分配（60 度或 90 度组）不知情，使用 GVL 用主或副管芯对所有患者的气管进行插管。
主要结果是在 62 秒或更短时间内成功经口气管插管。次要结果是实际插管时间（TTI）。
90 度组的插管成功率高于 60 度组（比值比 [OR] = 10.41；P < 0.03），60 秒内成功插管的患者为 60 例中的 59 例，而 60 度组为 60 例中的 51 例。7 例失败是由于 60 度管芯无法到达声门开口。其余 3 例失败与 TTI 超过 62 秒有关。
反向装载 ETT 的 90 度弯曲可弯曲管芯可更可靠地将 ETT 送达声门开口，并且成功率高于 60 度管芯。
