Moon Young-Jin, Kim Juyoung, Seo Dong-Woo, Kim Jae-Won, Jung Hye-Won, Suk Eun-Ha, Ha Seung-Il, Kim Sung-Hoon, Kim Joung-Uk
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Korea Health Promotion Foundation, Seoul, Korea.
J Dent Anesth Pain Med. 2015 Dec;15(4):207-212. doi: 10.17245/jdapm.2015.15.4.207. Epub 2015 Dec 31.
The ideal alternative airway device should be intuitive to use, yielding proficiency after only a few trials. The Clarus Video System (CVS) is a novel optical stylet with a semi-rigid tip; however, the learning curve and associated orodental trauma are poorly understood.
Two novice practitioners with no CVS experience performed 30 intubations each. Each trial was divided into learning (first 10 intubations) and standard phases (remaining 20 intubations). Total time to achieve successful intubation, number of intubation attempts, ease of use, and orodental trauma were recorded.
Intubation was successful in all patients. In 51 patients (85%), intubation was accomplished in the first attempt. Nine patients required two or three intubation attempts; six were with the first 10 patients. Learning and standard phases differed significantly in terms of success at first attempt, number of attempts, and intubation time (70% vs. 93%, 1.4 ± 0.7 vs. 1.1 ± 0.3, and 71.4 ± 92.3 s vs. 24.6 ± 21.9 s, respectively). The first five patients required longer intubation times than the subsequent five patients (106.8 ± 120.3 s vs. 36.0 ± 26.8 s); however, the number of attempts was similar. Sequential subgroups of five patients in the standard phase did not differ in the number of attempts or intubation time. Dental trauma, lip laceration, or mucosal bleeding were absent.
Ten intubations are sufficient to learn CVS utilization properly without causing any orodental trauma. A relatively small number of experiences are required in the learning curve compared with other devices.
理想的替代气道装置应使用直观，仅经过几次尝试就能熟练操作。Clarus视频系统（CVS）是一种新型的带有半刚性尖端的光导探条；然而，其学习曲线和相关的口腔牙齿创伤情况尚不清楚。
两名没有CVS经验的新手从业者每人进行30次插管操作。每次试验分为学习阶段（前10次插管）和标准阶段（剩余20次插管）。记录成功插管的总时间、插管尝试次数、易用性和口腔牙齿创伤情况。
所有患者均成功插管。51例患者（85%）首次尝试即完成插管。9例患者需要进行两到三次插管尝试；其中6例是在前10例患者中。学习阶段和标准阶段在首次尝试成功率、尝试次数和插管时间方面存在显著差异（分别为70%对93%、1.4±0.7对1.1±0.3、71.4±92.3秒对24.6±21.9秒）。前5例患者的插管时间比后5例患者长（106.8±120.3秒对36.0±26.8秒）；然而，尝试次数相似。标准阶段按5例患者顺序分组，在尝试次数或插管时间上没有差异。未出现牙齿创伤、唇裂或黏膜出血。
进行10次插管足以正确学会使用CVS，且不会造成任何口腔牙齿创伤。与其他装置相比，学习曲线所需的经验相对较少。
