Moritz Andreas, Heinrich Sebastian, Irouschek Andrea, Birkholz Torsten, Prottengeier Johannes, Schmidt Joachim
Department of Anesthesia, University Hospital of Erlangen, Erlangen, Germany.
J Emerg Med. 2017 Jan;52(1):8-15. doi: 10.1016/j.jemermed.2016.07.108. Epub 2016 Sep 29.
Single-use plastic blades (SUPB) and single-use metal blades (SUMB) for direct laryngoscopy and tracheal intubation have not yet been compared with reusable metal blades (RUMB) in difficult airway scenarios.
The purpose of our manikin study was to compare the effectiveness of these different laryngoscope blades in a difficult airway scenario, as well as in a difficult airway scenario with simulated severe inhalation injury.
Thirty anesthetists performed tracheal intubation (TI) with each of the three laryngoscope blades in the two scenario manikins.
In the inhalation injury scenario, SUPB were associated with prolonged intubation times when compared with the metal blades. In the inhalation injury scenario, both metal laryngoscope blades provided a quicker, easier, and safer TI. In the difficult airway scenario, intubation times were significantly prolonged in the SUPB group in comparison to the RUMB group, but there were no significant differences between the SUPB and the SUMB. In this scenario, the RUMB demonstrated the shortest intubation times and seems to be the most effective device.
Generally, results are in line with previous studies showing significant disadvantages of SUPB in both manikin scenarios. Therefore, metal blades might be beneficial, especially in the airway management of patients with inhalation injury.
在困难气道情况下，尚未对用于直接喉镜检查和气管插管的一次性塑料刀片（SUPB）和一次性金属刀片（SUMB）与可重复使用的金属刀片（RUMB）进行比较。
我们的人体模型研究旨在比较这些不同喉镜刀片在困难气道情况下以及在模拟严重吸入性损伤的困难气道情况下的有效性。
30名麻醉医生在两种模拟情况下使用三种喉镜刀片分别进行气管插管（TI）。
在吸入性损伤情况下，与金属刀片相比，SUPB与插管时间延长有关。在吸入性损伤情况下，两种金属喉镜刀片都能提供更快、更容易且更安全的气管插管。在困难气道情况下，与RUMB组相比，SUPB组的插管时间显著延长，但SUPB和SUMB之间无显著差异。在这种情况下，RUMB的插管时间最短，似乎是最有效的器械。
总体而言，结果与先前的研究一致，表明SUPB在两种人体模型情况下均存在明显劣势。因此，金属刀片可能有益，尤其是在吸入性损伤患者的气道管理中。
