Wetsch Wolfgang A, Schneider Andreas, Schier Robert, Spelten Oliver, Hellmich Martin, Hinkelbein Jochen
aDepartment of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne bInstitute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany.
Eur J Emerg Med. 2015 Oct;22(5):374-6. doi: 10.1097/MEJ.0000000000000230.
The success of tracheal intubation (TI) is unacceptably low in unconventional positions. Supraglottic airway devices (SAD) have become an important alternative. An airway manikin was placed in a car, simulating an entrapped motor vehicle accident victim. The rescuer only had access through the driver's door. Participants were (n = 25) anaesthesiologists with experience in prehospital emergency medicine. They attempted to secure the airway by TI or an SAD (Ambu AuraOnce, iGel, laryngeal tube) in a random sequence. Performance was compared using the Wilcoxon signed-rank test. P values less than 0.05 were considered statistically significant. Fastest effective ventilation was achieved with iGel (11.5 ± 6.9 s, P < 0.001), followed by a laryngeal mask (15.1 ± 5.6 s, P < 0.001) and a laryngeal tube (17.6 ± 5.3 s, P < 0.001); TI was the slowest (42.8 ± 23.9 s, comparator). iGel (P < 0.001) and laryngeal mask (P = 0.01) also significantly outperformed the laryngeal tube. First ventilation was achieved significantly faster with SADs compared with TI. Success rates were also higher when using SADs.
在非常规体位下，气管插管（TI）的成功率低得令人难以接受。声门上气道装置（SAD）已成为一种重要的替代方法。将一个气道人体模型放置在汽车内，模拟被困在机动车事故中的受害者。救援人员只能通过驾驶员车门进入。参与者为25名有院前急救医学经验的麻醉医生。他们按随机顺序尝试通过TI或SAD（Ambu AuraOnce、iGel、喉管）确保气道安全。使用Wilcoxon符号秩检验比较操作表现。P值小于0.05被认为具有统计学意义。使用iGel实现最快有效通气（11.5±6.9秒，P<0.001），其次是喉罩（15.1±5.6秒，P<0.001）和喉管（17.6±5.3秒，P<0.001）；TI最慢（42.8±23.9秒，作为对照）。iGel（P<0.001）和喉罩（P=0.01）也显著优于喉管。与TI相比，使用SAD时首次通气明显更快。使用SAD时成功率也更高。
