气管插管和喉罩在手术室与滑雪场雪道建立人工气道时间的比较

Time comparison of artificial airway establishment in operating room and on slope using endotracheal intubation and laryngeal mask

目的:比较手术室内和滑雪场雪道条件下,气管插管和喉罩置入的完成时间,探讨滑雪场雪道条件下人工气道建立的优选方法。方法:在滑雪场雪道上,以头下脚上位放置模拟人,由一名麻醉医生穿戴全套的滑雪服、头盔、雪镜、手套以及滑雪鞋,分别采用可视喉镜辅助下气管插管(气管插管组)和喉罩置入(喉罩组)的方法为模拟人建立人工气道,每种方法重复5次,记录人工气道建立的时间。在医院手术间内,将模拟人平放于手术床上,由同一名麻醉医生采用相同的方法完成人工气道建立,重复5次并记录时间。比较手术室内气管插管及喉罩置入的时间与滑雪场雪道完成同样操作所需要的时间差异是否有统计学意义。结果:手术室内,气管插管操作时间长于喉罩置入操作时间[(79.8±10.4)s vs.(53.4±2.7)s,P=0.005];滑雪场雪道上气管插管操作时间长于喉罩置入操作时间[(209.2±32.7)s vs.(72.2±3.1)s,P=0.001]。滑雪场雪道上气管插管完成时间长于手术室内气管插管完成时间(t=-7.851,P=0.001)。滑雪场雪道喉罩置入完成时间长于手术室内相同操作完成时间(t=-19.391,P<0.001)。结论:滑雪场雪道条件下,可视喉镜辅助下气管插管和喉罩置入均可较快完成人工气道建立,但所需时间均长于在手术室内完成相同操作所需要的时间;喉罩置入建立人工气道花费的时间短于可视喉镜引导下气管插管,在滑雪现场救援中可能具有一定优势。

Objective:To compare the completion time of endotracheal intubation and laryngeal mask implantation in operating room and on slope of ski resort,and to discuss the optimal method of estab-lishing artificial airway on slope of ski resort.Methods:The simulator was placed with the head under the feet on slope of ski resort.The artificial airway was established by tracheal intubation assisted by video laryngoscope(endotracheal intubation group)and laryngeal mask placement(laryngeal mask group)respectively by an anesthesiologist who wore full set of ski suits,helmets,goggles,gloves and ski boots.Each method was repeated 5 times,and the operation time of artificial airway establishment was recorded.While the simulated human was placed flat on the operating table in an operating room of a hospital,and the artificial airway was established by the same anesthesiologist using the same methods.Time was recorded and repeated for 5 times.The completion time of endotracheal intubation and laryngeal mask placement in the operating room and on the ski slope were compared.Results:The operating time of tracheal intubation in the operating room was longer than that of laryngeal mask placement[(79.8±10.4)s vs.(53.4±2.7)s,P=0.005],and the operating time of endotracheal intubation on the ski slope was longer than that of laryngeal mask placement[(209.2±32.7)s vs.(72.2±3.1)s,P=0.001].The time of endotracheal intubation group on the slope of the ski resort was longer than that in the opera-ting room(t=-7.851,P=0.001).The time of laryngeal mask group on the slope was longer than that in the operating room(t=-19.391,P<0.001).Conclusion:On ski slope,both of tracheal intubation assisted by video laryngoscope and laryngeal mask placement can quickly complete the establishment of artificial airway,but the time required is longer than that in the operating room.The time of laryngeal mask placement to establish artificial airway is shorter than that of tracheal intubation assisted video laryngoscope,which may have a certain advantage in ski rescue.