Saraçoğlu Ayten, Dal Didem, Baygın Ömer, Göğüş Fevzi Yılmaz
Department of Anaesthesiology and Reanimation, Marmara University School of Medicine, İstanbul, Turkey.
Turk J Anaesthesiol Reanim. 2016 Apr;44(2):76-80. doi: 10.5152/TJAR.2016.79553. Epub 2016 Apr 1.
Training students on simulators before allowing their direct contact with patients is well accepted. There is no clinical or manikin-based simulation study in the literature comparing tracheal intubation with Airtraq, laryngeal mask airway (LMA) CTrach and Macintosh laryngoscopes performed by medical students having no prior intubation experience.
After obtaining written informed consents, 123 participants were included in the study. The participants were asked to intubate the manikin five times with each device randomly. After all the participants had completed their fifth intubations, the measurements were performed. The primary outcome variables were the first-attempt success rate and the time for a successful intubation, while the secondary outcome variables were to determine the scores of dental trauma, the difficulty visual analogue scale and the optimization manoeuvres.
The LMA CTrach group revealed a significantly higher number of intubation attempts. The mean time for a successful intubation was the longest in the LMA CTrach group (17.66±8.22 s, p<0.05). Students defined the Airtraq as the easiest to use and the Macintosh laryngoscope as the most difficult device to use and learn. Dental trauma severity was significantly lower in the Airtraq group than in the other groups (p<0.05), and it was found to be 0 in 81.1% in the Airtraq group. The head extension optimization manoeuvre rate was significantly higher with the Macintosh laryngoscope than with the Airtraq laryngoscope (p<0.05).
This study, in which different types of laryngoscopes were compared, revealed that the Airtraq laryngoscope has advantages, such as shorter intubation duration, less additional optimization manoeuvres, less dental trauma intensity and is easier to learn compared with the LMA CTrach and Macintosh laryngoscopes.
在允许学生直接接触患者之前,先在模拟器上对他们进行培训已被广泛接受。文献中尚无基于临床或人体模型的模拟研究,比较无插管经验的医学生使用Airtraq喉镜、喉罩气道(LMA)CTrach和麦金托什喉镜进行气管插管的情况。
在获得书面知情同意书后,123名参与者被纳入研究。要求参与者使用每种设备对人体模型进行5次随机插管。所有参与者完成第5次插管后进行测量。主要结局变量为首次尝试成功率和成功插管时间,次要结局变量为确定牙齿创伤评分、困难视觉模拟量表评分和优化操作情况。
LMA CTrach组的插管尝试次数明显更多。LMA CTrach组成功插管的平均时间最长(17.66±8.22秒,p<0.05)。学生们认为Airtraq最易于使用而麦金托什喉镜是最难使用和学习使用的设备。Airtraq组的牙齿创伤严重程度明显低于其他组(p<0.05),且Airtraq组81.1%的牙齿创伤评分为0。麦金托什喉镜的头部伸展优化操作率明显高于Airtraq喉镜(p<0.05)。
这项比较不同类型喉镜的研究表明,与LMA CTrach和麦金托什喉镜相比,Airtraq喉镜具有一些优势,如插管持续时间更短、额外的优化操作更少、牙齿创伤强度更小且更易于学习。