新式的影像喉頭鏡（GlideScope(R)）是否可提供較佳的喉部視野？

Does A New Videolaryngoscope (GlideScope(R)) Provide Better Glottic Exposure?

背景：GlideScope(R) （Saturn Biomedical Systems Inc, Burnaby, British Columbia, Canada）是一新型的影像式喉頭鏡。它的設計對於改善喉部祝野有所助益。本試驗的目的在於比較傳統式Macintosh喉頭鏡與影像式喉頭鏡（GlideScope(R)）在喉部祝野的差異，藉以驗證影像式喉頭鏡（GlideScope(R)）在改善插管環境的幫助。方法：本試驗收集103個需要行全身麻醉的病人。給予fentanyl, propofol或thiopentone和muscle relaxant作為誘導藥物。挑管先行使用Macintosh blade （size 3），之後使用GlideScope(R)。應用grading of Cormack and Lehane紀錄二者喉部的最佳祝野等級。記錄困難插管的病人，並選擇其他的替代方式進行插管。結果：使用lideScope(R)插管，有44個案例（93.6%）喉部祝野有所改善，其中22個被視為困難插管者，有20位（90%）的喉部視野有所改善，並且都可成功插管。多數病人在首次插管便成功。結論：GlideScope(R)確實可提供較好的插管環境，而且學習上與傳統laryngoscope相似，較容易上手，不失為另一種替代的插管方式。

Background: The GlideScope(R) (Saturn Biomedical Systems Inc, Burnaby, British Columbia, Canada) is a new videolaryngoscope designed as an alternative to the conventional laryngoscope. It was designed to facilitate glottic exposure during tracheal intubation. This study assessed the effectiveness of the GlideScope(R) in providing glottic exposure. Methods: One hundred and three patients requiring general anesthesia for elective surgery were enrolled in this study. Under full monitoring, all patients were given fentanyl, propofol or thiopentone and muscle relaxant for induction. In each patient laryngoscopy was performed first with a Macintosh blade (size 3), then with the GlideScope(R). The optimal view of the larynx that could be achieved with each instrument was recorded and as-sessed using the grading scale of Cormack and Lehane (C&L grade). Intubation was performed with the GlideScope(R). Results: The grading decreased in the majority (93.6%, 44/47) of patients with C&L grade >1 when using the GlideScope(R). Of the 22 patients who were considered as subjects of difficult intubation, 20 had an improved lar- yngoscopic grade with GlideScope(R). One hundred and one patients were intubated successfully at the first attempt. Conclusions: The laryngeal view was better in the GildeScope(R) group using this grading system. The GlideScope(R) provided a better view of the glottis and is a useful alternative in airway management.