Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792-3272, USA.
J Anesth. 2011 Oct;25(5):721-6. doi: 10.1007/s00540-011-1205-5. Epub 2011 Jul 29.
This study characterizes the performance and success rate for fiberoptic-guided tracheal tube placement through the air-Q(®) Intubating Laryngeal Airway (air-Q).
Using a manikin, anesthesia trainees and staff anesthesiologists, experienced in fiberoptic-guided intubation, performed five consecutive fiberoptic-guided tracheal tube placements via the air-Q. Participant characteristics, procedure segment times, total procedure times, and observed failures were recorded. Linear mixed effect models with random slopes and intercepts were used to assess participant performance.
Ten anesthesia trainees and ten staff anesthesiologists participated. Anesthesia trainees were younger and had practiced for fewer years compared to staff anesthesiologists. Gender was equally distributed between the groups. Both segmental and overall procedure times decreased from the first to the fifth trial among all participants, independent of experience level and gender. Overall mean procedure time decreased from 102 ± 31 to 68 ± 14 s, representing a relative time reduction of 33% and a mean time difference of 34 s [95% confidence interval (CI) 22-47 s; p < 0.0001]. Tracheal tube placement was successful in all attempts; however, three tracheal tube dislodgements occurred during air-Q removal (overall procedure success 97%).
Fiberoptic-guided tracheal tube placement through the air-Q can be performed in a clinically acceptable period of time with high success by operators skilled in fiberoptic-guided intubation. Tracheal tube dislodgement during air-Q removal remains a potential risk that should be emphasized.
本研究旨在描述通过 air-Q（®）Intubating Laryngeal Airway（air-Q）进行纤维支气管镜引导下气管插管的性能和成功率。
使用模拟人，麻醉培训生和有纤维支气管镜引导插管经验的麻醉医生，对 air-Q 进行了五次连续的纤维支气管镜引导下气管插管。记录参与者特征、程序分段时间、总程序时间和观察到的失败。使用具有随机斜率和截距的线性混合效应模型来评估参与者的表现。
共有 10 名麻醉培训生和 10 名麻醉医生参加了这项研究。麻醉培训生比麻醉医生年轻，并且实践经验较少。两组的性别分布均匀。所有参与者的分段和总体程序时间都从第一次尝试到第五次尝试减少，与经验水平和性别无关。总平均程序时间从 102±31 秒减少到 68±14 秒，相对减少 33%，平均时间差异为 34 秒[95%置信区间（CI）22-47 秒;p<0.0001]。所有尝试均成功放置气管导管；然而，在 air-Q 移除过程中有 3 次气管导管移位（总程序成功率为 97%）。
熟练的纤维支气管镜引导插管医生可以在临床可接受的时间内通过 air-Q 进行纤维支气管镜引导下气管插管，并且成功率很高。在 air-Q 移除过程中发生气管导管移位仍然是一个潜在的风险，应予以重视。
