Department of Anesthesiology, The University of Michigan, 1500 E, Medical Center Dr,, 1H247, SPC 5048, Ann Arbor, MI, 48109-5048, USA.
BMC Anesthesiol. 2012 Jun 21;12:11. doi: 10.1186/1471-2253-12-11.
Videolaryngoscopy presents a new approach for the management of the difficult and rescue airway. There is little available evidence to compare the performance features of these devices in true difficult laryngoscopy.
A prospective randomized crossover study was performed comparing the performance features of the Macintosh Laryngoscope, Glidescope, Storz CMAC and Storz DCI videolaryngoscope. Thirty anesthesia providers attempted intubation with each of the 4 laryngoscopes in a high fidelity difficult laryngoscopy manikin. The time to successful intubation (TTSI) was recorded for each device, along with failure rate, and the best view of the glottis obtained.
Use of the Glidescope, CMAC and Storz videolaryngoscopes improved the view of the glottis compared with use of the Macintosh blade (GEE, p = 0.000, p = 0.002, p = 0.000 respectively). Use of the CMAC resulted in an improved view compared with use of the Storz VL (Fishers, p = 0.05). Use of the Glidescope or Storz videolaryngoscope blade resulted in a longer TTSI compared with either the Macintosh (GLM, p = 0.000, p = 0.029 respectively) or CMAC blades (GLM, p = 0.000, p = 0.033 respectively).
Unsurprisingly, when used in a simulated difficult laryngoscopy, all the videolaryngoscopes resulted in a better view of the glottis than the Macintosh blade. However, interestingly the CMAC was found to provide a better laryngoscopic view that the Storz DCI Videolaryngoscope. Additionally, use of either the Glidescope or Storz DCI Videolaryngoscope resulted in a prolonged time to successful intubation compared with use of the CMAC or Macintosh blade. The use of the CMAC during manikin simulated difficult laryngoscopy combined the efficacy of attainment of laryngoscopic view with the expediency of successful intubation. Use of the Macintosh blade combined expedience with success, despite a limited laryngoscopic view. The limitations of a manikin model of difficult laryngoscopy limits the conclusions for extrapolation into clinical practice.
视频喉镜为困难气道的管理提供了一种新方法。目前，比较这些设备在真正困难喉镜检查中性能特点的证据很少。
本研究为前瞻性随机交叉研究，比较了 Macintosh 喉镜、Glidescope、Storz CMAC 和 Storz DCI 视频喉镜的性能特点。30 名麻醉师在高保真困难喉镜模拟人上分别使用这 4 种喉镜进行插管。记录每种设备的插管成功时间（TTSI）、失败率和获得的最佳声门视图。
与 Macintosh 叶片相比，使用 Glidescope、CMAC 和 Storz 视频喉镜可改善声门视图（GEE，p=0.000，p=0.002，p=0.000）。与使用 Storz VL 相比，使用 CMAC 可获得更好的视野（Fisher，p=0.05）。与 Macintosh 叶片（GLM，p=0.000，p=0.029）或 CMAC 叶片（GLM，p=0.000，p=0.033）相比，使用 Glidescope 或 Storz 视频喉镜叶片可导致更长的 TTSI。
毫不奇怪，在模拟困难喉镜检查中使用时，所有视频喉镜都比 Macintosh 叶片获得更好的声门视图。然而，有趣的是，CMAC 被发现提供了比 Storz DCI 视频喉镜更好的喉镜视图。此外，与使用 CMAC 或 Macintosh 叶片相比，使用 Glidescope 或 Storz DCI 视频喉镜会导致插管成功时间延长。在模拟困难喉镜检查中使用 CMAC 可将喉镜视野的获得与插管成功的迅速结合起来。使用 Macintosh 叶片虽然喉镜视野有限，但仍能迅速成功。困难喉镜模拟人模型的局限性限制了将结论外推到临床实践的能力。
