Division of Emergency Medicine, University of Utah, Salt Lake City, UT, USA.
Ann Emerg Med. 2012 Mar;59(3):159-64. doi: 10.1016/j.annemergmed.2011.07.009. Epub 2011 Aug 10.
We compare laryngoscopic quality and time to highest-grade view between a face-to-face approach with the GlideScope and traditional flexible fiber-optic laryngoscopy in awake, upright volunteers.
This was a prospective, randomized, crossover study in which we performed awake laryngoscopy under local anesthesia on 23 healthy volunteers, using both a GlideScope video laryngoscopy face-to-face technique with the blade held upside down and flexible fiber-optic laryngoscopy. Operator reports of Cormack-Lehane laryngoscopic views and video-reviewed time to highest-grade view, as well as number of attempts, were recorded.
Ten women and 13 men participated. A grade II or better view was obtained with GlideScope video laryngoscopy in 22 of 23 (95.6%) participants and in 23 of 23 (100%) participants with flexible fiber-optic laryngoscopy (relative risk GlideScope video laryngoscopy versus flexible fiber-optic laryngoscopy 0.96; 95% confidence interval 0.88 to 1.04). Median time to highest-grade view for GlideScope video laryngoscopy was 16 seconds (interquartile range 9 to 34) versus 51 seconds (interquartile range 35 to 96) for flexible fiber-optic laryngoscopy. A distribution of interindividual differences demonstrated that GlideScope video laryngoscopy was, on average, 39 seconds faster than flexible fiber-optic laryngoscopy (95% confidence interval 0.2 to 76.9 seconds).
GlideScope video laryngoscopy can be used to obtain a Cormack-Lehane grade II or better view in the majority of awake, healthy volunteers when an upright face-to-face approach is used and was slightly faster than traditional flexible fiber-optic laryngoscopy. However, flexible fiber-optic laryngoscopy may be more reliable at obtaining high-grade views of the larynx. Awake, face-to-face GlideScope use may offer an alternative approach to the difficulty airway, particularly among providers uncomfortable with flexible fiber-optic laryngoscopy.
我们比较了面对面使用 GlideScope 与传统纤维光导喉镜在清醒、直立志愿者中进行最高等级视野的喉镜质量和时间。
这是一项前瞻性、随机、交叉研究，我们在 23 名健康志愿者中局部麻醉下进行清醒喉镜检查，使用 GlideScope 视频喉镜面对面技术，将叶片倒置，并使用纤维光导喉镜。记录操作员报告的 Cormack-Lehane 喉镜视图和视频审查的最高等级视图时间，以及尝试次数。
10 名女性和 13 名男性参与了研究。23 名参与者中的 22 名（95.6%）和 23 名参与者中的 23 名（100%）使用 GlideScope 视频喉镜获得了 II 级或更好的视野，而使用纤维光导喉镜获得了 23 名参与者中的 23 名（100%）（GlideScope 视频喉镜与纤维光导喉镜的相对风险 0.96；95%置信区间 0.88 至 1.04）。GlideScope 视频喉镜达到最高等级视野的中位时间为 16 秒（四分位间距 9 至 34），而纤维光导喉镜为 51 秒（四分位间距 35 至 96）。个体间差异的分布表明，GlideScope 视频喉镜的平均速度比纤维光导喉镜快 39 秒（95%置信区间 0.2 至 76.9 秒）。
当使用直立面对面方法时，GlideScope 视频喉镜可用于获得大多数清醒、健康志愿者的 Cormack-Lehane II 级或更好的视野，并且比传统纤维光导喉镜稍快。然而，纤维光导喉镜在获得喉部高等级视野方面可能更可靠。清醒、面对面的 GlideScope 使用可能为困难气道提供一种替代方法，特别是在那些不熟悉纤维光导喉镜的提供者中。
