Anestesia e Pesquisa Clínica
Acesso livre

Abstrato

Endotracheal Tube Insertion Time for a Cervical Stabilized Manikin using Airway Scope and Multi View Scope: A Randomized Manikin Study

Genji Shimpuku, Takeshi Yano, Isao Tsuneyoshi, Shuuji Uchimura, Shunsuke Kuroki, Yoshihumi Kodama and Yoshihiro Nagamine

Context: Cervical spine injury is one of the most difficult cases of airway management.

Objective: The aim of this study was to evaluate whether Multi View Scope (MVS) intubated more quickly and easily than conventional laryngoscope and Airway Scope (AWS).

Design: A randomized crossover trial using a manikin.

Setting: An airway-management training manikin was attached to the cervical neck collar. The manikin had inline cervical stabilization and it was difficult to open its mouth. The investigator counted the time of intubation and conducted post-intubation interviews of the participants.

Patients or other participants: 20 experienced anesthetists.

Interventions: The participants intubated the cervical injured manikin using 3 devices (laryngoscope, AWS, and MVS).

Main outcome measures: The first endpoint was the time to achieve insertion of the device and tracheal intubation. The second endpoint was the quality of intubation by measuring the Cormack-Lehane grade, the number of injuries to the manikin’s teeth, and the use of cricoid pressure. The data for the first endpoint were analyzed using the Bonferroni-Dunn test. The data for the second endpoint were analyzed using the Kruskal-Wallis test, followed by the Wilcoxon test with Bonferroni correction. Statistical significance was considered P<0.05.

Results: The time for intubation with LS, AWS, and MVS averaged 22.65 ± 8.29 s, 18.35 ± 6.66 s, and 14.70 ± 6.28 s, respectively. The time for intubation with MVS was shorter than that with LS. The time for inserting the device with LS, AWS, and MVS were, on average, 2.55 ± 1.19 s, 4.65 ± 1.63 s, and 2.10 ± 0.45 s, respectively. The time for inserting the device with LS and with MVS was shorter than that with AWS. With AWS and with MVS, all participants could intubate in grade 1. There was no clicking sound with MVS. There was no participant to push the manikin’s cricoid using AWS or MVS.

Conclusions: The time for intubation with MVS was shorter than that with LS or AWS. Using MVS, the participants were able to intubate without injuring the manikin’s teeth. MVS might be a useful device for a patient under manual inline axial stabilization without opening the mouth.