Aghamohammadi H, Massoudi N, Fathi M, Jaffari A, Gharaei B, Moshki A
Anesthesiology Department, Labaffinejad Hospital, Pasdaran, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Anesthesiology Department, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Med Life. 2015;8(Spec Iss 4):150-153.
Direct laryngoscopy (DL) is considered the most common method of tracheal intubation. On the other hand, evidence shows the growing role of video laryngoscopy in danger airway administration. Due to the importance of a proper training to accomplish an accurate and fast intubation by the student of anesthesia, this research was conducted to assess the effects of DL and video laryngoscopy (Glidescope VL) training on the success rate of tracheal intubation by low-skill students. 50 undergraduate students of anesthesiology took part in this randomized control educational intervention. Having no considerable experience in intubation, they were selected and divided randomly into two equal groups (n = 25); video-laryngoscopy via GlideScope VL and direct laryngoscopy (DL) via a Macintosh blade were prepared by the same experienced anesthesiologist. All the participants practiced intubation six times on the same mannequin within a routine airway situation. The maximum acceptable time for each intubation was 3 minutes and three times of successful intubation was considered as an appropriate intubation skill. The required time for laryngoscopy and intubation at each stage, the grade of glottis view, the reasons for an unsuccessful intubation and the amount of successful intubations were recorded and compared between groups. There was a clear variation between the 2 teams, in all the steps, based on the required time for laryngoscopy and intubation (p = 0.0001). Data analysis was performed by using repeated measures data which demonstrated that the necessary time for laryngoscopy and intubation during the study was clearly lower in the GlideScope VL team (p = .0001). In first five rounds of training, the glottis view in the DL group was significantly better than in the VL group (p < 0.05). Based on the result of today' study, routine airway intubation by using GlideScope VL is significantly faster than direct laryngoscopy. It seems that further studies are needed to investigate the effect of the educational program on different laryngoscopy and intubation situations.
直接喉镜检查（DL）被认为是气管插管最常用的方法。另一方面，有证据表明视频喉镜在困难气道管理中的作用日益凸显。鉴于适当培训对于麻醉专业学生准确快速完成插管的重要性，本研究旨在评估直接喉镜检查（DL）和视频喉镜（GlideScope VL）培训对低技能学生气管插管成功率的影响。50名麻醉学本科生参与了这项随机对照教育干预研究。由于他们在插管方面没有太多经验，因此被随机分为两组（n = 25）；由同一位经验丰富的麻醉医生准备通过GlideScope VL进行视频喉镜检查和通过麦氏喉镜进行直接喉镜检查（DL）。所有参与者在常规气道情况下在同一个人体模型上进行6次插管练习。每次插管的最长可接受时间为3分钟，成功插管3次被视为具备适当的插管技能。记录并比较两组在每个阶段进行喉镜检查和插管所需的时间、声门视野分级、插管失败的原因以及成功插管的次数。基于喉镜检查和插管所需时间，两组在所有步骤上都存在明显差异（p = 0.0001）。采用重复测量数据进行数据分析，结果表明GlideScope VL组在研究期间进行喉镜检查和插管所需的时间明显更短（p = 0.0001）。在前五轮培训中，DL组的声门视野明显优于VL组（p < 0.05）。基于今日的研究结果，使用GlideScope VL进行常规气道插管明显比直接喉镜检查更快。似乎需要进一步研究来调查该教育项目在不同喉镜检查和插管情况下的效果。
