Sut Esra Yildiz, Gunal Solmaz, Yazar Mehmet Akif, Dikmen Bayazit
Department of Anesthesiology, Ankara Training and Research Hospital, Ankara, Turquia.
Department of Anesthesiology, Ankara Training and Research Hospital, Ankara, Turquia.
Rev Bras Anestesiol. 2017 May-Jun;67(3):238-245. doi: 10.1016/j.bjan.2016.12.002. Epub 2016 Dec 29.
In this study, we evaluated the effectiveness of intubations by way of "Gum Elastic Bougie" and "Intubating Laryngeal Mask Airway" in endotracheal intubation of patients with simulated cervical trauma.
134 patients were included in the study. All patients were placed cervical collar for a simulated cervical trauma. Patients were allocated randomly into three groups: Group NI (n=45) intubation with Macintosh laryngoscopy, Group GEB (n=45) intubation with Gum Elastic Bougie, and Group ILMA (n=44) intubation with Intubating Laryngeal Mask Airway. The number of intubation attempts, success of intubation, duration of complete visualization of the larynx, duration of intubation, user's performance score, hemodynamic changes and the observed complications were recorded.
Success of intubation in the first attempt was highest in Group GEB while it was lowest in Group ILMA. Regarding the intubation success, rates of successful intubation were 95.6%, 84.4% and 65.9% in Groups GEB, NI, and ILMA, respectively. Durations of visualization of larynx and intubation were shorter in Groups NI and GEB than in Group ILMA. This difference was statistically significant (p<0.05) while there was no significant difference between Groups NI and GEB. The number of patients with "good" intubation performance was significantly higher in Group GEB while the number of patients with "poor" intubation performance was significantly higher in Group ILMA (p<0.05).
We conclude that GEB, which is cheap and easily accessible, should be an advantageous choice in cervical trauma patients for both the easeness of intubation and patient morbidity and mortality.
在本研究中,我们评估了在模拟颈椎创伤患者的气管插管中,使用“弹性橡胶探条”和“可插管喉罩气道”进行插管的有效性。
134例患者纳入本研究。所有患者均佩戴颈托以模拟颈椎创伤。患者被随机分为三组:NI组(n = 45)采用麦氏喉镜插管;GEB组(n = 45)采用弹性橡胶探条插管;ILMA组(n = 44)采用可插管喉罩气道插管。记录插管尝试次数、插管成功率、喉镜完全可视时间、插管时间、使用者操作评分、血流动力学变化及观察到的并发症。
首次插管成功率在GEB组最高,在ILMA组最低。关于插管成功率,GEB组、NI组和ILMA组的成功插管率分别为95.6%、84.4%和65.9%。NI组和GEB组的喉镜可视时间和插管时间短于ILMA组。这种差异具有统计学意义(p < 0.05),而NI组和GEB组之间无显著差异。GEB组插管操作“良好”的患者数量显著高于ILMA组,而ILMA组插管操作“较差”的患者数量显著高于GEB组(p < 0.05)。
我们得出结论,弹性橡胶探条价格便宜且易于获取,对于颈椎创伤患者而言,无论是插管的简易性还是患者的发病率和死亡率,它都应是一个有利的选择。