Randomized Evaluation of the Performance of Single-Use Laryngoscopes in Simulated Easy and Difficult Intubation
Randomized Evaluation of the Performance of Single-Use Laryngoscopes in Simulated Easy and Difficult Intubation
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一次性喉镜模拟易难插管性能的随机评价
DOI：
10.1097/01.sa.0000108472.38017.15
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发表时间：
2004
期刊：
影响因子：
--
通讯作者：
C. Bailey
中科院分区：
文献类型：
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作者：
C. Bailey
一次性喉镜的使用越来越多。使用Laerdal SimMan™患者模拟器对6种一次性喉镜与标准Macintosh喉镜进行比较。20名麻醉师试图用标准化的气道设置插管模拟器，允许声带的完整视图（“容易插管”）。然后改变气道设置，使仅可见声门后部（“插管困难”），并要求麻醉师再次插管模拟器。简易插管和困难插管均缩短了标准喉镜插管时间。简易插管时5台喉镜和困难插管时4台喉镜的表现明显差于Macintosh。在简单插管和困难插管喉镜测试中，Cormack和Lehane评分有显著差异。简单组和困难组声门开口可见百分率（POGO评分）差异无统计学意义（P< 0.01）。在Macintosh喉镜下POGO评分最高。在困难插管模拟中，与一次性喉镜相比，可重复使用的Macintosh喉镜较少使用支架，导致插管失败的次数较少，但差异无统计学意义。在测试的喉镜中，标准的可重复使用的Macintosh喉镜表现最好。Europa™是最好的一次性喉镜。一些一次性喉镜明显不如Macintosh，这引起了对其在临床实践中的使用的关注，特别是如果插管困难。
There is increasingly greater use of single-use laryngoscopes. Six types of single-use laryngoscopes were compared with the standard Macintosh laryngoscope using the Laerdal SimMan™ patient simulator. Twenty anesthetists tried to intubate the simulator with standardized airway settings, allowing a full view of the vocal cords (" easy intubation"). The airway settings were then changed so that only the posterior part of the glottis was visible (" difficult intubation"), and the anesthetists were asked to intubate the simulator again. The time to intubate with the standard laryngoscope was less in both easy and difficult intubations. The performance of five laryngoscopes during easy intubation and four during difficult intubation was markedly worse than that of the Macintosh. There was a marked difference in Cormack and Lehane grading between the laryngoscopes tested in both easy and difficult intubation. The percentage of glottic opening visible (POGO score) also varied between laryngoscopes in both the easy (P< 0.01) and difficult (P< 0.001) groups. The highest POGO scores were obtained with the Macintosh laryngoscopes. During the difficult intubation simulation, the reusable Macintosh laryngoscope required less use of a bougie and resulted in fewer failed intubations than the single-use laryngoscopes, but the differences did not reach statistical significance. Among the laryngoscopes tested, the standard reusable Macintosh laryngoscopes performed best. The Europa™ was the best single-use laryngoscope. Some single-use laryngoscopes were markedly inferior to the Macintosh, which raises concern over their use in clinical practice, especially if intubation is difficult.