The University of Texas Medical School at Houston, Houston, TX 77030-1501, USA.
Intern Emerg Med. 2012 Feb;7(1):59-63. doi: 10.1007/s11739-011-0691-7. Epub 2011 Sep 23.
Video laryngoscopes allow indirect visualization of the glottis and provide superior views of the glottis compared to direct laryngoscopes in patients with both normal and difficult airways, but it may be difficult to advance the endotracheal tube (ETT) through the vocal cords into the trachea, unless a stylet is used. We propose that the Endotrol(®) ETT may be an effective tool to facilitate video laryngoscope-assisted orotracheal intubation without the use of a stylet. After obtaining written and oral informed consent, 60-adult patients scheduled for elective surgery requiring general anesthesia with orotracheal intubation were enrolled. Patients were randomized, respectively, to 1 of 4 groups: Group A(1), (15 patients): McGrath(®) with Endotrol(®) ETT; Group A(2), (15 patients): McGrath(®) with GlideRite(®)-styletted standard ETT; Group B(1), (15 patients): GlideScope(®) with Endotrol(®) ETT; Group B(2), (15 patients): GlideScope(®) with GlideRite(®)-styletted standard ETT. Statistical analysis was performed with Stata (Stata Corp v10, College Station). Mean time to intubation was longer in the Endotrol(®) groups compared to the GlideRite(®) groups: 60.1 (31.6) vs. 44.4 (27.6) s (p < 0.05). It was subjectively more difficult to intubate using the Endotrol(®) than with a GlideRite(®)-styletted ETT (difficulty score median [range] 2 [1-5] vs. 1 [1-3], respectively). Three intubations using the Endotrol(®) were characterized as difficult, whereas there were no difficult intubations with the GlideRite(®)stylet. The Endotrol(®) ETT, as compared to a standard ETT with a non-malleable stylet, is associated with longer intubation times and a subjective increase in difficulty of use. It may, however, still be a clinically viable alternative in video laryngoscope-assisted orotracheal intubation when use of a rigid stylet is undesirable.
视频喉镜允许间接观察声门，并提供优于直接喉镜的声门视图，适用于正常和困难气道的患者，但可能难以将气管内导管（ETT）通过声带推进到气管中，除非使用引导管芯。我们提出，Endotrol（®）ETT 可能是一种有效的工具，可在不使用引导管芯的情况下促进视频喉镜辅助经口气管插管。在获得书面和口头知情同意后，纳入了 60 名计划接受全身麻醉和经口气管插管的择期手术的成年患者。患者随机分为 4 组中的 1 组：A 组（1）（15 例）：使用 McGrath（®）和 Endotrol（®）ETT；A 组（2）（15 例）：使用 McGrath（®）和 GlideRite（®）带管芯标准 ETT；B 组（1）（15 例）：使用 GlideScope（®）和 Endotrol（®）ETT；B 组（2）（15 例）：使用 GlideScope（®）和 GlideRite（®）带管芯标准 ETT。使用 Stata（StataCorp v10，College Station）进行统计分析。与 GlideRite（®）组相比，Endotrol（®）组的插管时间更长：60.1（31.6）比 44.4（27.6）s（p <0.05）。与使用 GlideRite（®）带管芯 ETT 相比，使用 Endotrol（®）插管主观上更困难（难度评分中位数[范围]为 2[1-5]比 1[1-3]）。3 例使用 Endotrol（®）的插管被认为是困难的，而使用 GlideRite（®）管芯则没有困难的插管。与标准 ETT 带不可弯曲管芯相比，Endotrol（®）ETT 与更长的插管时间和使用难度增加有关。然而，当不希望使用刚性管芯时，它可能仍然是视频喉镜辅助经口气管插管的一种可行的临床替代方案。
