Reinhart D J, Simmons G
Department of Anesthesiology, McKay-Dee Hospital, Ogden, Utah.
Ann Emerg Med. 1994 Aug;24(2):260-3. doi: 10.1016/s0196-0644(94)70139-3.
To determine the learning curve of nonphysician emergency personnel on placement of the laryngeal mask airway as compared to performance of endotracheal intubation.
Prospective, comparative, randomized, patient-blinded trial.
Regional hospital operating room.
Seven experienced paramedics and 12 respiratory therapists trained in endotracheal intubation.
Patients used as subjects were anesthetized and paralyzed. Each participant then performed placement of both the laryngeal mask airway and endotracheal tube on the same patient in random sequence. Both techniques were observed for speed, difficulty, and effectiveness.
The techniques were timed from the point at which the participant touched the patient to the time they were able to effectively ventilate the patient. Participants also were asked to rate the difficulty of each technique on a 100-mm visual analog score. Failure (three attempts without successful ventilation) rates also were monitored. The mean time to ventilate successfully with the laryngeal mask airway was significantly less than that with the endotracheal tube (38.9 +/- 1.9 seconds versus 206.1 +/- 31.9 seconds, P < .0001). The average number of attempts was 1.0 +/- 0.0 for the laryngeal mask airway and 2.22 +/- 0.21 for the endotracheal tube (P < .01). No one failed to place the laryngeal mask airway; and ten of 19 (52.6%, P < .01) failed to perform endotracheal intubation. The endotracheal tube had a significantly higher rating of difficulty than did the laryngeal mask airway (67.3 versus 8.64, P < .0001).
确定非医师急救人员放置喉罩气道相对于气管插管操作的学习曲线。
前瞻性、对比性、随机、患者盲法试验。
地区医院手术室。
7名经验丰富的护理人员和12名接受过气管插管培训的呼吸治疗师。
将用作受试者的患者麻醉并使其肌肉松弛。然后，每位参与者以随机顺序在同一名患者身上进行喉罩气道和气管导管的放置操作。观察两种技术的速度、难度和有效性。
记录从参与者接触患者到能够有效为患者通气的时间。还要求参与者在100毫米视觉模拟评分上对每种技术的难度进行评分。同时监测失败率（三次尝试均未成功通气）。使用喉罩气道成功通气的平均时间显著短于气管插管（38.9±1.9秒对206.1±31.9秒，P<.0001）。喉罩气道的平均尝试次数为1.0±0.0次，气管插管为2.22±0.21次（P<.01）。无人未能成功放置喉罩气道；19人中有10人（52.6%，P<.01）气管插管失败。气管导管的难度评分显著高于喉罩气道（67.3对8.64，P<.0001）。
