Normal havayolu senaryosunda beş farklı laringoskopa ait randomize, crossover, manken bazlı bir çalışma

Öz

Amaç:  Direkt laringoskopi trakeal entübasyon eğitiminde kullanılan geleneksel bir metoddur. Ancak bu alanda ustalaşmak zordur. Videolaringoskopi havayolu yönetiminde deneyimsiz medikal personel eğitimi için yaygın olarak kabul görmüş bir tekniktir. Bu çalışmada deneyimsiz kullanıcıların direkt ve indirekt laringoskoplardaki performanslarını karşılaştırmayı amaçladık.Gereç ve yöntemler: Daha önce trakeal entübasyon deneyimi bulunmayan 58 birinci sınıf anestezi teknikerliği öğrencisi çalışmaya dahil edildi. Standart 3 no’lu Macintosh, Miller, McCoy, McGrath, Storz C-Mac laringoskopları kullanıldı. Katılımcılardan AirMan mankeni her aygıtla beşer kez entübe etmeleri istendi. Katılımcıların bilgisayar oyunlarına karşı yatkınlıkları da sorgulandı. Tüm öğrenciler beşinci entübasyonlarını tamamladığında altıncı entübasyonları için başarılı trakeal entübasyon süresi, girişim sayısı, başarı oranı, dental travma şiddeti ve kullanılan optimizasyon manevraları kaydedildi.Bulgular: Başarılı entübasyon süresi 5.34±2.19 sn ile C-Mac laringoskop için en düşüktü. Optimizasyon manevra gereksinimi ve ek entübasyon girişimleri C-Mac ve McGrath laringoskoplar için Macintosh, Miller and McCoy laringoskoplarla karşılaştırıldığında anlamlı olarak daha düşüktü (p < 0.001). Dental travma insidansı C-Mac laringoskop kullanımında anlamlı olarak daha düşüktü (p < 0.001). Entübasyon kolaylığı üzerine Görsel analog skala skorları C-Mac laringoskopla anlamlı olarak daha düşüktü. Bilgisayar oyunlarına yatkınlıkla ilişkili bir avantaj dökümente edilemedi.Sonuç: Sonuç olarak normal havayolu senaryosunda C-Mac’ın trakeal entübasyon için daha yüksek genel başarı oranı ve daha düşük dental travma insidansı sağladığı ortaya konuldu.

Anahtar Kelimeler

• Havayolu
• entübasyon
• laringoskop

A randomized, crossover model-based study of five different laryngoscopes in normal airway scenario

Öz

Objectives: Direct laryngoscopy is a conventional method that has been taught in endotracheal intubation training. However, it is difficult to become skilled. Videolaryngoscopy has become a widely accepted technique for training both novice and inexperienced medical staff on airway management. We aimed to compare the performances of novices using direct and indirect laryngoscopes.

Materials and methods: Fifty eight first-year anesthesia nurse students without previous tracheal intubation experience were included in the study.

Standard size 3 Macintosh, Miller, McCoy, McGrath, Storz C-Mac laryngoscopes were used. The participants were asked to intubate the AirMan manikin five times with each device. The participants were also asked for their familiarity with computer games. After all the students completed their fifth intubations; the duration of successful tracheal intubation, number of attempts, success rate, severity of the dental trauma, and the used optimization maneuvers were recorded in the course of students’ sixth intubations.

Results: Time to successful intubation was the shortest for C-Mac laryngoscope with 5.34±2.19 sec. The requirement of optimization maneuvers (12.1%) and additional intubation attempts (1.7%) were significantly lower with C-Mac and McGrath laryngoscopes compared to Macintosh, Miller and McCoy laryngoscopes (p<0.001). Dental trauma incidence was significantly lower during the use of C-Mac laryngoscope (p<0.001). The VAS score on the ease of intubation were significantly lower with C-Mac laryngoscope. No advantages related to the familiarity with computer games were documented.

Conclusion: In conclusion, C-Mac was observed to provide a higher overall success rate for tracheal intubation and less dental trauma incidence when it was used in a normal airway scenario.

Anahtar Kelimeler

• Airway
• intubation
• laryngoscope

Kaynakça

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