Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany.
Resuscitation. 2012 Jun;83(6):740-5. doi: 10.1016/j.resuscitation.2011.11.024. Epub 2011 Dec 7.
The aim of the present study was to evaluate whether different video laryngoscopes (VLs) facilitate endotracheal intubation (ETI) faster or more secure than conventional laryngoscopy in a manikin with immobilized cervical spine.
After local ethics board approval, a standard airway manikin with cervical spine immobilization by means of a standard stiff collar was placed on a trauma stretcher. We compared times until glottic view, ETI, cuff block and first ventilation were achieved, and verified the endotracheal tube position, when using Macintosh laryngoscope, Glidescope Ranger, Storz C-MAC, Ambu Pentax AWS, Airtraq, and McGrath Series5 VLs in randomized order. Wilcoxon signed-rank test and McNemar's test were used for statistical analysis; p<0.05 was considered as significant.
Twenty-three anaesthetists (mean age 32.1±4.9 years, mean experience in anaesthesia of 6.9±4.8 years) routinely involved in the management of multitrauma patients participated. The primary study end point, time to first effective ventilation, was achieved fastest when using Macintosh laryngoscope (21.0±7.6s) and was significantly slower with all other devices (Airtraq 33.2±23.9 s, p=0.002; Pentax AirwayScope 32.4±14.9 s, p=0.001; Storz C-MAC 34.1±23.9 s, p<0.001; McGrath Series5 101.7±108.3 s, p<0.001; Glidescope Ranger 46.3±59.1 s, p=0.001). Overall success rates were highest when using Macintosh, Airtraq and Storz C-MAC devices (100%), and were lower in Ambu Pentax AWS and Glidescope Ranger (87%, p=0.5) and in McGrath Series5 device (72.2%, p=0.063).
When used by experienced anaesthesiologists, video laryngoscopes did not facilitate endotracheal intubation in this model with an immobilized cervical spine in a faster or more secure way than conventional laryngoscopy. However, data was gathered in a standardized model and further studies in real trauma patients are desirable to verify our findings.
本研究旨在评估在颈椎固定的人体模型中，与传统喉镜相比，不同的视频喉镜（VL）是否能更快或更安全地进行气管插管（ETI）。
在获得当地伦理委员会批准后，使用标准硬领将颈椎固定在创伤担架上的标准气道人体模型。我们比较了使用 Macintosh 喉镜、Glidescope Ranger、Storz C-MAC、Ambu Pentax AWS、Airtraq 和 McGrath Series5 VL 时达到声门视图、ETI、套囊阻塞和首次通气的时间，并验证了气管内导管的位置。采用 Wilcoxon 符号秩检验和 McNemar 检验进行统计学分析；p<0.05 被认为具有统计学意义。
23 名麻醉师（平均年龄 32.1±4.9 岁，平均麻醉经验 6.9±4.8 年）常规参与多创伤患者的管理。主要研究终点，即首次有效通气时间，使用 Macintosh 喉镜最快（21.0±7.6s），而使用所有其他设备则明显较慢（Airtraq 33.2±23.9 s，p=0.002；Pentax AirwayScope 32.4±14.9 s，p=0.001；Storz C-MAC 34.1±23.9 s，p<0.001；McGrath Series5 101.7±108.3 s，p<0.001；Glidescope Ranger 46.3±59.1 s，p=0.001）。使用 Macintosh、Airtraq 和 Storz C-MAC 设备的总体成功率最高（100%），而使用 Ambu Pentax AWS 和 Glidescope Ranger 设备的成功率较低（87%，p=0.5），使用 McGrath Series5 设备的成功率较低（72.2%，p=0.063）。
在本研究中，经验丰富的麻醉师使用视频喉镜在颈椎固定的模型中进行气管插管时，与传统喉镜相比，并没有更快或更安全地完成操作。然而，本研究的数据是在标准化模型中收集的，需要进一步在真实创伤患者中进行研究来验证我们的发现。
