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全麻时间与直接喉镜和视频喉镜在婴儿中首次插管成功率的关系:一项回顾性观察研究。

The relationship between years of anesthesia experience and first-time intubation success rate with direct laryngoscope and video laryngoscope in infants: a retrospective observational study.

机构信息

Department of Anesthesiology, Hokkaido University Hospital, N14 W5, Sapporo, 060-8648, Japan.

Department of Anesthesiology, Hakodate Central Hospital, 3-2 Honcho, 040-8585, Hakodate, Japan.

出版信息

J Anesth. 2022 Dec;36(6):707-714. doi: 10.1007/s00540-022-03106-y. Epub 2022 Sep 20.

Abstract

PURPOSE

Studies in adults have reported that video laryngoscope is more useful than direct laryngoscope when training less experienced anesthesiologists. However, whether this is true for infants remains unclear. Therefore, this study aimed to evaluate whether the use of video laryngoscope would result in smaller differences in success rate according to anesthesiologists' expertise than those in direct laryngoscope.

METHODS

Medical records and video recordings from the operating room of patients aged < 1 year who underwent non-cardiac surgery between March 2019 and September 2021 were reviewed. Tracheal intubations between April 8, 2020, and June 20, 2021, were excluded due to the shortage of video laryngoscope blades during the COVID-19 pandemic. Rates of first-time tracheal intubation success were compared by years of anesthesia experience and initial intubation device.

RESULTS

In total, 125 of 175 tracheal intubations were analyzed (direct laryngoscope group, n = 72; video laryngoscope group, n = 53). The first-time tracheal intubation success rate increased with years of experience as an anesthesiologist in the direct laryngoscope group (odds ratio OR 1.70, 95% confidence interval CI 1.15, 2.49; P = 0.0070), but not the video laryngoscope group (OR 0.99, 95% CI 0.74, 1.35; P = 0.99).

CONCLUSION

The differences in success rate according to the anesthesiologists' years of experience were non-significant when using video laryngoscope in infants, compared to those in direct laryngoscope.

摘要

目的

成人研究报告称,在培训经验较少的麻醉师时,视频喉镜比直接喉镜更有用。然而,这对于婴儿是否正确尚不清楚。因此,本研究旨在评估在婴儿中使用视频喉镜是否会导致成功率的差异小于直接喉镜,这取决于麻醉师的专业知识。

方法

回顾了 2019 年 3 月至 2021 年 9 月期间接受非心脏手术的年龄<1 岁的患者的手术记录和手术室录像。由于在 COVID-19 大流行期间视频喉镜刀片短缺,2020 年 4 月 8 日至 2021 年 6 月 20 日期间的气管插管被排除在外。比较了麻醉经验年限和初始插管设备对首次气管插管成功率的影响。

结果

总共分析了 175 次气管插管中的 125 次(直接喉镜组 n=72;视频喉镜组 n=53)。在直接喉镜组中,麻醉师经验年限与首次气管插管成功率呈正相关(优势比 OR 1.70,95%置信区间 CI 1.15-2.49;P=0.0070),但在视频喉镜组中并非如此(OR 0.99,95%置信区间 CI 0.74-1.35;P=0.99)。

结论

与直接喉镜相比,在婴儿中使用视频喉镜时,根据麻醉师经验年限的成功率差异不显著。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4662/9487847/7c5970a54544/540_2022_3106_Fig1_HTML.jpg

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