Kim Kyu Nam, Jeong Mi Ae, Oh You Na, Kim Soo Yeon, Kim Ji Yoon
Department of Anesthesiology and Pain Medicine, Hanyang University Hospital, Seoul, Republic of Korea.
J Int Med Res. 2018 Jan;46(1):258-271. doi: 10.1177/0300060517726229. Epub 2017 Aug 23.
Objective To determine whether intubation education using the Pentax Airway Scope (AWS) in normal airways is more useful than direct laryngoscopy (Macintosh laryngoscope) in novice personnel. Methods Eleven intern doctors without intubation experience performed 60 sequential intubations with each device on a manikin and 10 sequential intubations in adult patients. The time required for successful intubation, percentage of glottic opening (POGO) score, number of intubation attempts, and number of dental injuries were analyzed for each intubation technique. Results The mean (standard deviation) time required for successful intubation decreased as the number of intubations increased and was significantly shorter with the Pentax AWS than direct laryngoscope [22.6 (7.3) vs. 29.6 (10.0) and 33.0 (8.0) vs. 44.7 (5.6) s, respectively] in both the manikin and clinical studies. The Pentax AWS was also associated with higher POGO scores than the direct laryngoscope [81.7 (8.9) vs. 55.1 (13.2) and 80.9 (9.7) vs. 49.6 (16.5), respectively] and fewer intubation attempts. Fewer dental injuries occurred with the Pentax AWS in the manikin study. Conclusions Novices performed intubation more rapidly and easily with an improved laryngeal view using the Pentax AWS. We suggest that intubation education with video laryngoscopy should be mandatory along with direct laryngoscope training.
目的 确定在正常气道中,使用宾得气道镜(AWS)进行插管培训对新手而言是否比直接喉镜检查(麦金托什喉镜)更有用。方法 11名无插管经验的实习医生在模拟人身上使用每种设备依次进行60次插管,并在成年患者中依次进行10次插管。分析每种插管技术成功插管所需时间、声门开放百分比(POGO)评分、插管尝试次数和牙齿损伤次数。结果 在模拟人和临床研究中,成功插管所需的平均(标准差)时间均随着插管次数的增加而减少,且使用宾得AWS时显著短于直接喉镜[分别为22.6(7.3)秒对29.6(10.0)秒以及33.0(8.0)秒对44.7(5.6)秒]。与直接喉镜相比,宾得AWS的POGO评分也更高[分别为81.7(8.9)对55.1(13.2)以及80.9(9.7)对49.6(16.5)],且插管尝试次数更少。在模拟人研究中,使用宾得AWS时牙齿损伤更少。结论 新手使用宾得AWS进行插管时速度更快且更容易,喉镜视野有所改善。我们建议视频喉镜插管培训应与直接喉镜培训一样成为强制性要求。