Ueki Ryusuke, Komasawa Nobuyasu, Hirose Munetaka, Kaminoh Yoshiroh
Department of Anesthesiology and Pain Medicine Hyogo College of Medicine Nishinomiya Hyogo Japan.
Department of Anesthesiology Osaka Medical College Osaka Wakayama Japan.
Acute Med Surg. 2015 Jun 30;2(4):263-266. doi: 10.1002/ams2.126. eCollection 2015 Oct.
Fiber-optic tracheal intubation is an essential technique to secure the airway for difficult airway and cervical cord injury victims. However, there is an anxiety about the vocal cord passage of tracheal tubes because of the potential of collision with the surroundings of the vocal cords. This study aimed to examine the utility of the Aintree Intubation Catheter in nasotracheal and orotracheal intubation.
Participants were 21 anesthesiologists with more than 2 years of experience in clinical anesthesia. Participants attempted fiber-optic tracheal intubation through the oral or nasal cavity with or without the Aintree Intubation Catheter in random order. The success rate of tracheal intubation, intubation time, and collision with the glottis were recorded. Participants also evaluated the subjective difficulty of the entire intubation process and passing the tracheal tube through the glottis using a Visual Analogue Scale.
There were no significant differences in intubation time or Visual Analogue Scale scores for passing the tracheal tube through the glottis between nasal and oral intubation, regardless of the use of the Aintree Intubation Catheter. However, the catheter significantly reduced the number of collisions with the glottis in both routes (nasal, = 0.026; oral, = 0.017).
Our findings that the Aintree Intubation Catheter is effective in reducing collisions with the glottis during nasal and oral fiber-optic intubation suggest that Aintree Intubation Catheter use may reduce the risk of mechanical injury related to airway obstruction.
对于困难气道和颈椎损伤患者，纤维支气管镜引导下气管插管是确保气道安全的一项重要技术。然而，由于气管导管有可能与声带周围组织发生碰撞，人们对导管通过声带存在担忧。本研究旨在探讨安特里插管导管在鼻气管插管和口气管插管中的应用效果。
研究对象为21名具有2年以上临床麻醉经验的麻醉医生。参与者随机顺序尝试在使用或不使用安特里插管导管的情况下，经口腔或鼻腔进行纤维支气管镜引导下气管插管。记录气管插管成功率、插管时间以及与声门的碰撞情况。参与者还使用视觉模拟评分法评估整个插管过程以及气管导管通过声门的主观难度。
无论是否使用安特里插管导管，经鼻插管和经口插管在插管时间或气管导管通过声门的视觉模拟评分方面均无显著差异。然而，该导管在两种途径（经鼻，P = 0.026；经口，P = 0.017）中均显著减少了与声门的碰撞次数。
我们的研究结果表明，安特里插管导管在经鼻和经口纤维支气管镜插管过程中能有效减少与声门的碰撞，这提示使用安特里插管导管可能降低与气道梗阻相关的机械性损伤风险。
