Thierbach A, Piepho T, Göbler S, Rützler K, Frass M, Kaye A D, Robak O
Department of Anesthesia, Intensive Care Medicine, Emergency Medicine and Pain Therapy, Klinikum Idar-Oberstein, Germany -
Minerva Anestesiol. 2015 Dec;81(12):1311-7. Epub 2015 Jan 23.
Supraglottic airway devices (SAD) provide an effective way for managing difficult airways. Numerous SADs have been developed in recent years. We compared three SADs utilizing simulated airways. The major aim of this study was to provide evidence for the efficacy of SADs in the management of simulated difficult airway situations.
The study utilized an airway simulation manikin (Laerdal SimMan® 3G) to assess feasibility and time to final placement of three different airway devices (the classic laryngeal mask airway [LMA], the Laryngeal tube [LT], and the EasyTube® [EzT]). Thirty anesthesiologists inserted each of the SADs under standard physiologic airway conditions (STD) as well as pathological airway conditions, including tongue edema (TE) and trismus combined with limited mobility of the cervical spine (TCS), mimicking a patient with cramps.
In STD and TE, all participants were able to successfully place the LMA, LT, and EzT correctly. In TCS, one participant failed to place the LMA correctly, whereas six participants failed to place the LT correctly (P=0.031). Under STD and TE conditions, we found a significantly longer time to final placement with the EzT (P=0.001). Under TCS conditions, there was no significant difference between the tested SADs. Under STD conditions, the participants rated the LMA best (P<0.001). Under TE and TCS condition, the EzT was significantly higher rated (P<0.001).
The EzT showed benefits in two difficult airway situations (TE and TCS) in a prospective manikin study amongst anesthesiologists.
声门上气道装置（SAD）为处理困难气道提供了一种有效方法。近年来已研发出众多SAD。我们利用模拟气道对三种SAD进行了比较。本研究的主要目的是为SAD在处理模拟困难气道情况中的有效性提供证据。
本研究使用气道模拟人体模型（Laerdal SimMan® 3G）来评估三种不同气道装置（经典喉罩气道[LMA]、喉管[LT]和易管®[EzT]）的可行性及最终放置时间。30名麻醉医生在标准生理气道条件（STD）以及包括舌水肿（TE）和牙关紧闭合并颈椎活动受限（TCS，模拟有痉挛的患者）在内的病理气道条件下插入每种SAD。
在STD和TE情况下，所有参与者均能成功正确放置LMA、LT和EzT。在TCS情况下，一名参与者未能正确放置LMA，而六名参与者未能正确放置LT（P = 0.031）。在STD和TE条件下，我们发现EzT的最终放置时间明显更长（P = 0.001）。在TCS条件下，所测试的SAD之间无显著差异。在STD条件下，参与者对LMA的评价最佳（P < 0.001）。在TE和TCS条件下，EzT的评价明显更高（P < 0.001）。
在前瞻性人体模型研究中，对于麻醉医生而言，EzT在两种困难气道情况（TE和TCS）中显示出优势。
