Vargas Maria, Pastore Antonio, Aloj Fulvio, Laffey John G, Servillo Giuseppe
Section of Anesthesia and Intensive care, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Via Pansini 16, Naples, Italy.
Section of Anesthesia and Intensive care, Anesthesia and Intensive Care Unit, IRCCS Neuromed, Pozzilli, IS, Italy.
BMC Anesthesiol. 2017 Feb 20;17(1):25. doi: 10.1186/s12871-017-0318-2.
Videolaryngoscopy has become increasingly attractive for the routine management of the difficult airway. Glidescope® is well studied in the literature while imago V-Blade® is a recent videolaryngoscope. This is a feasibility study with 1:1 case-control sequential allocation comparing Imago V-Blade ® and Glidescope® in predicted difficult airway settings.
Two senior anesthesiologists with no clinical experience in video assisted intubation but previously trained in a simulated scenario, performed the endotracheal intubations with Imago V-Blade® and Glidescope®. A third experienced anesthesiologist supervised the procedures. Forty-two patients, 21 for each group, with the presence of predicted difficult airway according to the Italian guideline were included. The primary end point is the feasibility of intubation. The secondary end-points are the success to intubate in the first attempt, the intubation time, the Cormack and Lehane score view, the comparison of the intubation difficulty scale (IDS) score and the need for maneuvers to aid the endotracheal intubation comparing Imago V-Blade® and Glidescope®.
The intubation was achieved in 100% of cases in both groups. No differences were found in the first-attempt success rate (p = 0.383), intubation time (p = 0.280), Cormack and Lehane score view (p = 0.799) and IDS score (p = 0.252). Statistical differences were found in external laryngeal pressure (p = 0.005), advancement of the blade (p = 0.024) and use of increasing lifting force (p = 0.048).
This feasibility study showed that the intubation with the newly introduced Imago V-Blade® is feasible. Further randomized and/or non-inferiority trials are needed to evaluate the benefit of Imago V-Blade® in this procedure.
Clinicaltrials.gov NCT02897518 . Retrospectively registered 25 August 2016.
视频喉镜在困难气道的常规管理中越来越具有吸引力。Glidescope® 在文献中已有充分研究，而imago V-Blade® 是一种新型视频喉镜。这是一项在预测的困难气道情况下对imago V-Blade® 和Glidescope® 进行1:1病例对照序贯分配的可行性研究。
两名没有视频辅助插管临床经验但之前在模拟场景中接受过培训的资深麻醉医生，使用imago V-Blade® 和Glidescope® 进行气管插管。第三名经验丰富的麻醉医生监督操作过程。根据意大利指南，纳入42例预计存在困难气道的患者，每组21例。主要终点是插管的可行性。次要终点包括首次尝试插管成功、插管时间、Cormack和Lehane分级视野、比较插管难度量表（IDS）评分以及比较imago V-Blade® 和Glidescope® 在气管插管时辅助操作的需求。
两组患者插管成功率均为100%。首次尝试成功率（p = 0.383）、插管时间（p = 0.280）、Cormack和Lehane分级视野（p = 0.799）以及IDS评分（p = 0.252）均无差异。在外喉部压力（p = 0.005）、镜片推进（p = 0.024）和使用增加的提升力（p = 0.048）方面发现了统计学差异。
这项可行性研究表明，新引入的imago V-Blade® 插管是可行的。需要进一步的随机和/或非劣效性试验来评估imago V-Blade® 在该操作中的益处。
Clinicaltrials.gov NCT02897518。于2016年8月25日进行回顾性注册。
