教师辅助托下颌对初学者Bonfils硬质纤维支气管镜引导气管插管术学习效果的影响

Effect of teacher-assisted jaw thrust maneuver on learning effectiveness of Bonfils fiberscope-guided tracheal intubation for beginners

目的评价教师辅助托下颌对初学者Bonfils硬质纤维支气管镜(简称纤维硬镜)引导气管插管术学习效果的影响。方法纳入2020年4月至2021年3月北京协和医院麻醉科规范化培训在陪医师48名作为学员,进行Bonfils纤维硬镜培训并随机分为2组(n=24):独立组及辅助组。全麻诱导后,独立组学员独立进行Bonfils纤维硬镜引导气管插管操作,辅助组学员在教师托起患者下颌的辅助下进行操作。记录首次气管插管成功情况、气管插管时间、教师指导次数、学员学习信心评分。结果与独立组比较,辅助组首次气管插管成功率升高,气管插管时间缩短,学习信心评分升高(P<0.05),教师指导次数差异无统计学意义(P>0.05)。结论对于Bonfils纤维硬镜引导气管插管的初学者,教师辅助托起患者下颌有助于提高学习效果,并增加学习信心。

Objective To evaluate the effect of teacher-assisted jaw thrust maneuver on the learning effectiveness of Bonfils fiberscope-guided tracheal intubation for the beginners.Methods Forty-eight accompanying physicians who were receiving residents standardized training in the Department of Anesthesiology,Peking Union Medical College from April,2020 to March 2021 and served as trainees were enrolled in this study.The trainees received Bonfils fiberscope training and were randomly divided into independent group(n=24)and assisted group(n=24).After induction of general anesthesia,the trainees independently performed the Bonfils fiberscope-guided endotracheal intubation operation in independent group,and trainees performed the operation with the assistance of the teacher′s jaw thrust maneuver in assisted group.The success of intubation at first attempt,duration of intubation,times of teachers′guidance and scores for trainees′learning confidence were recorded.Results Compared with independent group,the success rate of intubation at first attempt was significantly increased,the duration of intubation was shortened,scores for trainees′learning confidence was increased(P<0.05),and no significant change was found in the times of teachers′guidance in assisted group(P>0.05).Conclusion For the beginners learning Bonfils fiberscope-guided tracheal intubation,teacher-assisted jaw thrust maneuver is helpful in raising the learning effectiveness and increasing the beginners′learning confidence.