Cooper S D, Benumof J L, Ozaki G T
Department of Anesthesiology, University of California, San Diego Medical Center 92103.
Anesth Analg. 1994 Nov;79(5):965-70. doi: 10.1213/00000539-199411000-00025.
The Bullard laryngoscope (BL) is a new device for managing the difficult airway. Previous publications on the BL are primarily descriptive, and fail to use internal controls (i.e., determine the best intubating mechanism) or external controls (i.e., compare the BL to a known standard such as conventional laryngoscopy). Therefore, we attempted to determine the best of four intubating mechanisms described for the BL (independently styletted endotracheal tube [ETT], the Bullard intubating forceps, an ETT with a directional tip or the new dedicated intubating stylet) and to determine whether time to successful intubation with the BL using the best intubating mechanism correlates with conventional grade of laryngoscopic view. The new intubating stylet provided the optimal intubating method; fewer attempts were required (1.1 vs 1.7, P = 0.005), and it took less time to successful tracheal intubation (39 +/- 34 s vs 83 +/- 74 s, P = 0.004) compared to the three other intubating mechanisms. Our results also suggest that the time to successful intubation with the BL using the intubating stylet was not affected by the conventional laryngoscopic grade; it was just as easy (and difficult) to intubate a conventional Grade I laryngoscopic view patient (full glottic view) as it was to intubate a conventional Grade III laryngoscopic view patient (visualization of just the epiglottis) with the BL. There were two failed intubations with the BL (3%) due to an inability to trap the epiglottis.(ABSTRACT TRUNCATED AT 250 WORDS)
Bullard喉镜（BL）是一种用于处理困难气道的新型设备。以往关于BL的出版物主要是描述性的，未使用内部对照（即确定最佳插管机制）或外部对照（即将BL与传统喉镜检查等已知标准进行比较）。因此，我们试图确定为BL描述的四种插管机制中最佳的一种（独立装有管芯的气管内导管[ETT]、Bullard插管钳、带有定向尖端的ETT或新型专用插管管芯），并确定使用最佳插管机制通过BL成功插管的时间是否与传统喉镜视野分级相关。新型插管管芯提供了最佳的插管方法；与其他三种插管机制相比，所需尝试次数更少（1.1次对1.7次，P = 0.005），气管插管成功所需时间更短（39±34秒对83±74秒，P = 0.004）。我们的结果还表明，使用插管管芯通过BL成功插管的时间不受传统喉镜分级的影响；用BL为传统I级喉镜视野患者（能看到完整声门）插管与为传统III级喉镜视野患者（仅能看到会厌）插管一样容易（和困难）。有两次使用BL插管失败（3%），原因是无法夹住会厌。（摘要截短至250字）
