Kotera Atsushi, Irie Hiroki, Iwashita Shinsuke, Taniguchi Junichi, Kasaoka Shunji, Kinoshita Yoshihiro
Department of Emergency and General Medicine Kumamoto University Hospital Kumamoto Japan.
Department of Intensive Care Kumamoto University Hospital Kumamoto Japan.
Acute Med Surg. 2014 Oct 20;2(2):138-142. doi: 10.1002/ams2.88. eCollection 2015 Apr.
We compared the utility of the conventional Macintosh laryngoscope, the Pentax Airway Scope, and the McGrath MAC video laryngoscope under restricted cervical motion using a manikin.
We recruited 36 participants into the simulation study. The manikin's cervical motion was restricted with a cervical collar and a head immobilizer, as occurs in trauma cases. We recorded the time to intubation and the success rate of the intubations.
Data are medians and ranges. The time to intubation under normal and restricted cervical motion were 22.5 (10-78) and 23 (9-119) s with the Macintosh laryngoscope, 13.5 (5-50) and 14 (7-119) s with the Airway Scope, and 13 (6-32) and 18 (7-80) s with the McGrath MAC video laryngoscope. The differences in the time to intubation between normal and restricted cervical motion were significant only with the McGrath MAC ( = 0.0008). With restricted cervical motion, the times to intubation in the Airway Scope attempts were significantly shorter than those in the Macintosh laryngoscope ( = 0.0005) and McGrath MAC ( = 0.0282) attempts. The success rates under normal and restricted cervical motion were 100% and 80.6% with the Macintosh laryngoscope ( = 0.0054), 100% and 100% with the Airway Scope, and 100% and 97.2% with the McGrath MAC, respectively.
In the present study, the Airway Scope was the best among the three devices. However, the differences between the Airway Scope and the McGrath MAC video laryngoscope may not be serious in a clinical situation. Data were gathered using a manikin, and further studies will be necessary.
我们使用人体模型比较了传统的麦金托什喉镜、宾得气道镜和麦格拉斯MAC视频喉镜在颈椎活动受限情况下的实用性。
我们招募了36名参与者进行模拟研究。如在创伤病例中一样，使用颈托和头部固定器限制人体模型的颈椎活动。我们记录了插管时间和插管成功率。
数据为中位数和范围。使用麦金托什喉镜时，正常和颈椎活动受限时的插管时间分别为22.5（10 - 78）秒和23（9 - 119）秒；使用气道镜时分别为13.5（5 - 50）秒和14（7 - 119）秒；使用麦格拉斯MAC视频喉镜时分别为13（6 - 32）秒和18（7 - 80）秒。仅麦格拉斯MAC的正常和颈椎活动受限时插管时间差异具有显著性（P = 0.0008）。在颈椎活动受限时，气道镜插管尝试的时间显著短于麦金托什喉镜（P = 0.0005）和麦格拉斯MAC（P = 0.0282）的插管尝试时间。麦金托什喉镜在正常和颈椎活动受限时的成功率分别为100%和80.6%（P = 0.0054），气道镜分别为100%和100%，麦格拉斯MAC分别为100%和97.2%。
在本研究中，气道镜是三种设备中最佳的。然而，在临床情况下，气道镜和麦格拉斯MAC视频喉镜之间的差异可能并不严重。数据是使用人体模型收集的，有必要进行进一步研究。
