Department of Anaesthesia, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
Department of Anaesthesia, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Anaesthesia. 2016 Aug;71(8):908-14. doi: 10.1111/anae.13516. Epub 2016 May 27.
We compared awake fibreoptic intubation with awake intubation using the Pentax Airway Scope(®) in 40 adult patients. Sedation was achieved using a target-controlled remifentanil infusion of 1-5 ng.ml(-1) and midazolam. The airway was anaesthetised with lidocaine spray and gargle. The total procedure time - a composite of sedation time, topical anaesthesia time and intubation time - was recorded. The operator's impression of the ease of the procedure and the patients' reported comfort were recorded on a 0-100 mm visual analogue scale. The median (IQR [range]) for total procedure time was 900 (739-1059 [616-1215]) s with the fibrescope and 651 (601-720 [498-900]) s with the Pentax Airway Scope (p = 0.0001). The median (IQR [range]) intubation time was 420 (283-480 [120-608]) s with the fibrescope and 183 (144-220 [107-420]) s with the Pentax Airway Scope (p = 0.0002). The median (IQR [range]) visual analogue scores for the operator's ease of intubation for the fibrescope and Pentax Airway Scope were 83.6 (72.0-98.0 [49.0-100.0]) and 86.8 (84.0-91.0 [61.0-100.0]), respectively (p = 0.3507). The median (IQR [range]) visual analogue score for patient comfort was 85.5 (81.0-97.0 [69.0-100.0]) and 79.4 (74.0-85.0 [59.0-100.0]) for the fibrescope and Pentax Airway Scope, respectively (p = 0.06). Total procedure time was significantly shorter with the Pentax Airway Scope compared with the fibrescope, with no difference in procedure difficulty or patient discomfort.
我们比较了 40 例成年患者清醒纤维支气管镜插管与清醒使用 Pentax 气道镜（®）插管。镇静采用靶控输注瑞芬太尼 1-5ng/ml 和咪达唑仑。气道用利多卡因喷雾和漱口麻醉。记录镇静时间、局部麻醉时间和插管时间的总和，即总操作时间。操作者对操作难易程度的印象和患者的舒适度报告以 0-100mm 视觉模拟量表记录。纤维支气管镜组的总操作时间中位数（IQR[范围]）为 900（739-1059[616-1215]）s，Pentax 气道镜组为 651（601-720[498-900]）s（p=0.0001）。纤维支气管镜组的插管时间中位数（IQR[范围]）为 420（283-480[120-608]）s，Pentax 气道镜组为 183（144-220[107-420]）s（p=0.0002）。纤维支气管镜和 Pentax 气道镜的操作者插管难易程度的中位数（IQR[范围]）视觉模拟评分分别为 83.6（72.0-98.0[49.0-100.0]）和 86.8（84.0-91.0[61.0-100.0]）（p=0.3507）。纤维支气管镜和 Pentax 气道镜的患者舒适度中位数（IQR[范围]）视觉模拟评分分别为 85.5（81.0-97.0[69.0-100.0]）和 79.4（74.0-85.0[59.0-100.0]）（p=0.06）。与纤维支气管镜相比，Pentax 气道镜的总操作时间明显缩短，而操作难度和患者不适无差异。
