Department of Anaesthesia, Warrington and Halton NHS Trust, Lovely Lane, Warrington, WA51QG, UK.
Eur J Anaesthesiol. 2011 Mar;28(3):175-80. doi: 10.1097/EJA.0b013e328340c383.
A randomised, cross-over study was designed to validate a new model of graded difficulty (based on mandibular space reduction) in the Laerdal 'SimMan' mannnequin and to suggest functional comparisons between Macintosh. Glidescope Video Laryngoscope, Truview EVO2 and Airtraq.
Twenty anaesthetists attempted intubation with all four laryngoscopes in three settings: easy, intermediate (based on a custom-made removable prosthetic insert) and difficult ('tongue oedema', a mannnequin feature). Laryngoscopic view and time to intubate were the primary outcome measures. Other measures were successful intubation, ease of laryngoscopy [visual analogue scale (VAS)] and intubation (VAS), tongue compression score and number of attempts.
Between settings comparisons demonstrated that Macintosh, Glidescope and Airtraq had worsening scores from easy to intermediate with lesser changes for Truview. However, with the intermediate to difficult comparison, Airtraq was the only blade with no worsening of scores. Within-blade comparisons showed that Macintosh was superior over all in both the easy and intermediate settings, whereas Airtraq was the most successful blade in the difficult setting.
Our study suggests that Glidescope and, to some extent Truview, are functionally similar to Macintosh and suffer from similar limitations in the difficult setting. On the contrary, Airtraq was functionally unique in providing good laryngeal exposure in the difficult setting and without excessive tongue compression.
本研究设计了一项随机交叉研究，旨在验证莱德尔“SimMan”人体模型中基于下颌间隙减小的新难度分级模型，并对 Macintosh、Glidescope Video 喉镜、Truview EVO2 和 Airtraq 之间的功能进行比较。
20 名麻醉医师在三种条件下使用四种喉镜进行插管尝试：容易、中等（基于定制可移动义齿插件）和困难（“舌肿胀”，是人体模型的一个特征）。喉镜视野和插管时间是主要的观察指标。其他观察指标包括成功插管、喉镜操作难易度（视觉模拟评分（VAS））、插管难易度（VAS）、舌压迫评分和尝试次数。
不同条件之间的比较表明，Macintosh、Glidescope 和 Airtraq 的评分从容易到中等逐渐变差，而 Truview 的变化较小。然而，从中等到困难的比较来看，只有 Airtraq 刀片的评分没有恶化。同一刀片之间的比较表明，Macintosh 在容易和中等条件下均优于其他刀片，而 Airtraq 刀片在困难条件下的成功率最高。
我们的研究表明，Glidescope 和在一定程度上 Truview 在功能上与 Macintosh 相似，并且在困难条件下存在相似的限制。相反，Airtraq 在困难条件下提供良好的喉部暴露而没有过度的舌压迫方面具有独特的功能。
