Annales francaises d'anesthesie et de reanimation · 1998
[Evaluation of training on intubation with a rigid fiber optic laryngoscope (UpsherScope)].
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Dounas M, Mercier F J, Valmier M, Laboutique X, Benhamou D
Аннотация
OBJECTIVE: To evaluate the learning of tracheal intubation with a new rigid fibreoptic laryngoscope (UpsherScope).
STUDY DESIGN: Open prospective study.
PATIENTS: Five investigators used the UpsherScope to intubate the trachea in 164 patients scheduled for gynaecological surgery requiring tracheal intubation. All patients were of physical class ASA I or II and criteria for difficult intubation were negative.
METHODS: After muscle relaxation, 120 seconds were allowed to intubate the trachea with the UpsherScope. If intubation had not been achieved by that time, the attempt was considered as a failure and the trachea was intubated using conventional laryngoscopy.
RESULTS: The overall success rate with the UpsherScope was 73%. Forty-five tracheas could not be intubated with the device within 120 seconds. The inability to insert the tracheal tube through the vocal cords despite a good view of the larynx (23/45) or the inability to visualise the glottis because of secretions (21/45), were the two main causes of failure.
CONCLUSION: The UpsherScope, a new rigid fibreoptic laryngoscope devised for routine and difficult intubation, is robust and allows the view of the tracheal tube passing between the vocal cords. However, in this study the intubation success rate remained low and was not improved by further experience. No benefit was found with the UpsherScope in patients with normal airways. Further studies are necessary to assess its efficiency in cases of difficult intubation.
STUDY DESIGN: Open prospective study.
PATIENTS: Five investigators used the UpsherScope to intubate the trachea in 164 patients scheduled for gynaecological surgery requiring tracheal intubation. All patients were of physical class ASA I or II and criteria for difficult intubation were negative.
METHODS: After muscle relaxation, 120 seconds were allowed to intubate the trachea with the UpsherScope. If intubation had not been achieved by that time, the attempt was considered as a failure and the trachea was intubated using conventional laryngoscopy.
RESULTS: The overall success rate with the UpsherScope was 73%. Forty-five tracheas could not be intubated with the device within 120 seconds. The inability to insert the tracheal tube through the vocal cords despite a good view of the larynx (23/45) or the inability to visualise the glottis because of secretions (21/45), were the two main causes of failure.
CONCLUSION: The UpsherScope, a new rigid fibreoptic laryngoscope devised for routine and difficult intubation, is robust and allows the view of the tracheal tube passing between the vocal cords. However, in this study the intubation success rate remained low and was not improved by further experience. No benefit was found with the UpsherScope in patients with normal airways. Further studies are necessary to assess its efficiency in cases of difficult intubation.