글라이드스코프(Glidescope®)를 사용한 기관 삽관 시 성문부 노출 방법에 따른 삽관 성공률 및 소요 시간
Comparison of Intubation Success Rate and Times Required for Intubation by Glottic Exposure Methods with Glidescope®
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Background: The glottis can be exposed by a Glidescope® during endotracheal intubation using either the epiglottis or valleculae elevation method. We compared the epiglottis and valleculae elevation methods for endotracheal intubations performed with a Glidescope® using differences in success rate, time spent for tracheal intubation and percent of glottic opening. Methods: Forty medical students without experience using a Glidescope® participated in this prospective, randomized study in which they intubated a tracheal tube into a manikin. All participants performed tracheal intubation using the 2 forementioned methods. Twenty students exposed the vocal cord by placing the blade tip in the valleculae (valleculae elevation method; VEM). The other 20 students directly elevated the epiglottis with the blade (epiglottis elevation method; EEM). We separated intubating time into 3 parts: turnaround time to exposing the vocal cord, tube passing time and first ventilating time. Results: The success rate of tracheal intubation using VEM (86.7%, 104/120) was higher than that using EEM (65.8%, 79/120) (p <0.001). VEM resulted in a lower total intubation time (VEM vs. EEM, 23.5 ± 5.3 vs. 29.0 ± 8.7, p = 0.001). The key factor of this difference was the tube passing time (VEM vs. EEM, 7.4 ± 2.5 vs. 12.8 ± 7.4, p < 0.001). Conclusions: Exposing the vocal cord by using VEM during tracheal intubation with a Glidescope® can increase the success rate of tracheal intubation and shorten the time of endotracheal intubation in novices.
Abstract
Background: The glottis can be exposed by a Glidescope® during endotracheal intubation using either the epiglottis or valleculae elevation method. We compared the epiglottis and valleculae elevation methods for endotracheal intubations performed with a Glidescope® using differences in success rate, time spent for tracheal intubation and percent of glottic opening. Methods: Forty medical students without experience using a Glidescope® participated in this prospective, randomized study in which they intubated a tracheal tube into a manikin. All participants performed tracheal intubation using the 2 forementioned methods. Twenty students exposed the vocal cord by placing the blade tip in the valleculae (valleculae elevation method; VEM). The other 20 students directly elevated the epiglottis with the blade (epiglottis elevation method; EEM). We separated intubating time into 3 parts: turnaround time to exposing the vocal cord, tube passing time and first ventilating time. Results: The success rate of tracheal intubation using VEM (86.7%, 104/120) was higher than that using EEM (65.8%, 79/120) (p <0.001). VEM resulted in a lower total intubation time (VEM vs. EEM, 23.5 ± 5.3 vs. 29.0 ± 8.7, p = 0.001). The key factor of this difference was the tube passing time (VEM vs. EEM, 7.4 ± 2.5 vs. 12.8 ± 7.4, p < 0.001). Conclusions: Exposing the vocal cord by using VEM during tracheal intubation with a Glidescope® can increase the success rate of tracheal intubation and shorten the time of endotracheal intubation in novices.
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