Pentax-AWS, a New Videolaryngoscope, is More Effective Than the Macintosh Laryngoscope for Tracheal Intubation in Patients With Restricted Neck Movements: A Randomized Comparative Study
Y. Enomoto; T. Asai; T. Arai; K. Kamishima; Y. Okuda
Br J Anaesth. 2008;100(4):544-548. ©2008 Oxford University Press
Posted 06/04/2008
Abstract and Introduction
Abstract
Background: We studied whether laryngoscopy and tracheal intubation were easier when using the Pentax-AWS (Tokyo, Japan), a new videolaryngoscope, than when applying the Macintosh laryngoscope, during manual in-line neck stabilization.
Methods: In 203 anaesthetized patients with manual in-line neck stabilization, we inserted the Pentax-AWS and a Macintosh laryngoscope, in turn, and recorded the view of the glottis and time taken to laryngoscopy. The success rate of tracheal intubation (within 120 s) and time to intubation were also recorded.
Results: The view of the glottis was significantly better with the Pentax-AWS than with the Macintosh laryngoscope (P<0.001). For the Macintosh laryngoscope, the view was obscured in 22 of 203 patients (11%) (Grade 3 in 21 patients and Grade 4 in one patient), whereas for the Pentax-AWS, the glottis was always clearly seen (Grade 1). Time taken to see the glottis with the Pentax-AWS [mean (SD): 6.0 (3.1) s] was significantly shorter than with the Macintosh laryngoscope [11.0 (5.0) s] (95% CI for difference: 4-6 s). The success rate of tracheal intubation with the Pentax-AWS (all of 99 patients) was significantly higher than with the Macintosh laryngoscope (93 of 104 patients) (P=0.001). Time taken for intubation was similar between the Macintosh laryngoscope [51 (27) s] and the Pentax-AWS [54 (14) s] (95% CI for difference: -9 to 3 s).
Conclusions: In patients with stabilized neck, the Pentax-AWS provided a better view of the glottis and a higher success rate of tracheal intubation, compared with the conventional Macintosh laryngoscope.
作者: xyz-cn99 时间: 2008-9-13 13:47
Pentax-AWS 为一套电子影像喉头镜，除了提供病人呼吸道实时影像外，插管过程也更为顺畅，快速及准确. 可弯曲光纤内嵌明亮白色LED灯，让困难插管不再是难事，即使不熟悉插管的医护人员也可以轻易上手，成为最佳的辅助工具.
作者: xyz-cn99 时间: 2008-9-13 13:47
分解了看看
作者: xyz-cn99 时间: 2008-9-13 13:48
插管示教
作者: xyz-cn99 时间: 2008-9-13 13:55
操作教程：
Step 1. Remove PBlade from sterile package. Insert Pentax-AWS' flexible scope tip into the PBlade opening.
Step 2. Align arrow marks on Pentax-AWS body and PBlade. Pull back on metal ring to attach blade.
Step 3. Turn ring to lock PBlade.
Step 4. Apply anti-fogging liquid to video scope window on the PBlade.
Step 5. Apply lubricant to endotracheal tube.
Step 6. Starting from the front tip of the PBlade, insert the endotracheal tube into the guide slot.
Step 1. Turn on Pentax-AWS video monitor. Check to ensure video scope and monitor are working properly.
Step 2. Carefully insert PBlade into the patient's mouth until the Pentax-AWS unit is full upright and has reached the midline.
Step 3. Visualize the epiglottis on the monitor and lift to reveal the patient's airway.
Step 4. Align target symbol on glottis opening.
Step 5. Push endotracheal turbe forward to appropriate depth.
Step 6. Detach tube from insertion guide. Gently remove PBlade from the patient's mouth.
Turn ring to unlock PBlade. Pull back on mounting unit to release PBlade and remove from the Pentax-AWS unit. Dispose PBlade.
Scrub outside of the Pentax-AWS unit with gauze soaked in enzymatic detergent. Gently rinse the Pentax-AWS unit under running tap water.
To disinfect the Pentax-AWS unit, prepare a solution of 80 cc of 95% ethanol alcohol mixed with 20 cc of distilled water. Soak gauze in solution and wipe all surfaces of the Pentax-AWS unit.
作者: xyz-cn99 时间: 2008-9-13 15:57
操作详细教程，PDF文件
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作者: 仁心 时间: 2008-9-13 17:15
好家伙，够先进的哦，变成了可视插管，可能很昂贵吧！
作者: 神Goddy 时间: 2008-9-13 20:32
与可视喉镜有什么区别呢？？？除了显像系统以外，前端的镜片还有差别啊 ？？？
[ 本帖最后由 神Goddy 于 2008-9-13 20:33 编辑 ]
作者: 幻水梦天831 时间: 2008-9-16 20:48
不错 这样我们就不用直对着病人的口腔了 并且可以预防传染病
作者: 李任 时间: 2008-9-26 13:50
看是国人在操作，太酷了！
这么好的东西太诱人了，只有成人用的镜片吗？哪儿有啊、报价多少？
作者: rextao 时间: 2008-9-26 14:37
本帖最后由 zhsj869303 于 2010-2-21 16:31 编辑
我们医院也有这种可视喉镜 用过几次 不过对于绝对的困难气道 这个东西还是不一定搞得赢哈 不要被表面现象所迷惑 比如说下颌骨骨折的病人 不可能用它来插 一般都会用纤维支气管镜 插起来也很恼火的 有的要助手把患者的舌头拉出来才可以顺利插好！
作者: 小雪 时间: 2008-10-1 22:27
很先进呀，只是不知道能不能推广，感觉还是急诊科用这个合适
作者: tealion 时间: 2008-10-5 14:12
够先进的,希望有机会实际操作,体会一下,
作者: 灿烂涅槃 时间: 2008-10-6 22:12
好家伙，只是不知道要多少钱一套啊？
作者: gdmcsky 时间: 2008-10-18 12:09
厉害，我刚学插管呢。
作者: supt7528 时间: 2009-4-13 14:18
第一次见，挺新颖。不知用起来是否方便。
作者: 小界 时间: 2009-4-13 17:08
感觉意义不大 仅仅是价格方面 感觉操作起来也不是很好 如果病人会厌大把气管挡住而导管又和叶片没什么可活动空间就很难插了啊
作者: cjwzzzz 时间: 2009-4-13 18:19
好家伙,说明麻醉与科技在共同进步!
作者: anemenglihua 时间: 2009-4-17 23:58
标题: 回复 1# xyz-cn99 的帖子
看起来很方便，只是应该成本比较昂贵，也有一定的局限性。
作者: wyx267 时间: 2009-4-18 08:39
麻醉药物和器械这些年改进和更新的还是很快的啊
作者: 独上西楼听风 时间: 2010-2-18 21:54
是的，声门上气道工具越来越丰富了
尤其是要解决看得到插不到的问题
这个东西不错
我觉得我们的托人应该把它山寨了，呵呵
作者: budian0722 时间: 2013-1-11 20:13
回复 6# xyz-cn99
我们麻醉科已经用了一年,很好用.和这个不太一样.
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