Arslan Zehra Ipek, Alparslan Volkan, Ozdal Pınar, Toker Kamil, Solak Mine
Anaesthesiology and Reanimation, Kocaeli University Medical Faculty, Umuttepe, Kocaeli, Turkey.
J Anesth. 2015 Dec;29(6):893-8. doi: 10.1007/s00540-015-2052-6. Epub 2015 Jul 29.
Airway management in emergency settings can be difficult due to limited access to the patient. The use of video laryngoscopes along with the Fastrach™ device improves tracheal intubation; however, the use of such devices in a face-to-face intubation model has not been evaluated in adult patients.
After obtaining official approval from the Local Research Ethics Committee and written informed consent from the patients, 120 patients were enrolled in this prospective randomized study. The patients were ASA I and ASA II according to the American Society of Anesthesiologists Physical Status Classification System. Rocuronium was administered for neuromuscular blockade following standard anesthesia monitoring and induction. The patients were divided into three groups (40 patients per group) and their tracheas were intubated via a face-to-face approach with the Airtraq™, Glidescope™ or Fastrach™ devices.
The intubation success rates of the Airtraq™, Glidescope™ and Fastrach™ devices were similar (100, 98 and 90 %; p = 0.07). The insertion time for the Airtraq™ [8.5 (6-11) s] was the shortest followed by the Glidescope™ [11 (7-19) s] and the Fastrach™ [16.5 (14.3-21.8) s; p < 0.001]. The intubation time for the Airtraq™ [14 (10.3-18.8) s] was shorter than the Glidescope™ [25 (18-45) s], and Fastrach™ devices [46.5 (40-65) s; p < 0.001]. The Glidescope™ device required a greater number of optimization maneuvers (p = 0.009) and intubation attempts than the Airtraq™ (p = 0.004). Esophageal intubation (p = 0.001) and mucosal damage were more common in the Fastrach™ group (p = 0.03).
The Airtraq™ device provided faster insertion and intubation times and enabled better Cormack-Lehane grades. Additionally, the Airtraq™ device required the minimum number of optimization maneuvers and was associated with fewer complications and fewer intubation attempts than the Glidescope™ and Fastrach™ devices during face-to-face tracheal intubation.
在紧急情况下，由于接近患者的机会有限，气道管理可能会很困难。使用视频喉镜以及Fastrach™设备可改善气管插管；然而，在面对面插管模型中使用此类设备在成年患者中尚未得到评估。
在获得当地研究伦理委员会的正式批准并获得患者的书面知情同意后，120名患者被纳入这项前瞻性随机研究。根据美国麻醉医师协会身体状况分类系统，患者为ASA I级和ASA II级。在标准麻醉监测和诱导后给予罗库溴铵进行神经肌肉阻滞。将患者分为三组（每组40名患者），并通过面对面的方法使用Airtraq™、Glidescope™或Fastrach™设备对其气管进行插管。
Airtraq™、Glidescope™和Fastrach™设备的插管成功率相似（分别为100%、98%和90%；p = 0.07）。Airtraq™的插入时间最短，为[8.5（6 - 11）秒]，其次是Glidescope™[11（7 - 19）秒]和Fastrach™[16.5（14.
3 - 21.8）秒；p < 0.001]。Airtraq™的插管时间[14（10.3 - 18.8）秒]短于Glidescope™[25（18 - 45）秒]和Fastrach™设备[46.5（40 - 65）秒；p < 0.001]。与Airtraq™相比，Glidescope™设备需要更多的优化操作（p = 0.009）和插管尝试次数（p = 0.004）。食管插管（p = 0.001）和黏膜损伤在Fastrach™组中更为常见（p = 0.03）。
Airtraq™设备提供了更快的插入和插管时间，并能实现更好的Cormack - Lehane分级。此外，在面对面气管插管过程中，与Glidescope™和Fastrach™设备相比，Airtraq™设备所需的优化操作次数最少，并发症更少，插管尝试次数也更少。
