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??? ??? Optiscope?? ??? ????? ? ????

机译:??? ??? Optiscope ?? ??? ?????? ? ????

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Background: Optiscope? is a semi-rigid fiberscope for endotracheal intubation. A camera attached to the distal end of the stylet shows the laryngeal view through an adjustable LCD-monitor attached at the handle. The aim of this study was to evaluate the learning curve of skilled anesthesiologists in the use of Optiscope?. Methods: Eighty-patients with normal airways were randomly assigned to four anesthesiologists, who did not have previous experience of intubation with Optiscope?. After induction of general anesthesia, the four investigators performed 20 intubations each, using the Optiscope?. Time to intubation (TTI), number of intubation attempts, and reasons of prolonged TTI were evaluated. Results: The success rate of intubation was 98.8%. The TTI was significantly faster in 16th–20th patients (35.0 s, interquartile range 27.3–41.4) than in the first 10 patients (54.1 s, interquartile range 31.2–75.5) (P = 0.006). All patients after the 16th intubation were intubated at the first attempt. Frequent problems encountered were difficulty in getting the stylet tip under the epiglottis, and mucous secretion obscuring the laryngeal anatomy. Conclusions: Optiscope? is an effective device for endotracheal intubation. About 15 intubations in patients with normal airways provided clinically adequate experience to the skilled anesthesiologists. Additional maneuver of airway opening such as jaw thrust and sufficient removal of oral secretion, are suggested to reduce TTI.
机译:背景:Optiscope?是用于气管插管的半刚性纤维镜。安装在管心针远端的摄像机通过安装在手柄上的可调节LCD显示器显示喉部视图。这项研究的目的是评估使用Optiscope?的熟练麻醉师的学习曲线。方法:将80例气道正常的患者随机分配给四位麻醉师,他们之前没有使用Optiscope进行插管的经验。全身麻醉诱导后,四名研究人员分别使用Optiscope?进行了20次插管。评估了插管时间(TTI),插管尝试次数以及TTI延长的原因。结果:插管成功率为98.8%。在第16至20例患者(35.0 s,四分位数范围27.3–41.4)中,TTI显着快于在前10例患者(54.1 s,四分位数范围31.2–75.5)中(P = 0.006)。第16次插管后的所有患者均在首次尝试时进行了插管。遇到的常见问题是很难将管心尖端置于会厌下方,并且粘液分泌会遮盖喉部解剖结构。结论:Optiscope?是气管插管的有效装置。在气道正常的患者中进行约15次插管,为熟练的麻醉师提供了足够的临床经验。建议采取更多的气道开放操作,例如下颌推力和充分清除口腔分泌物,以减少TTI。

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