GlideRite®硬质管芯与Flex-it®可弯曲管芯在佩戴半硬质颈托患者视频喉镜插管中的比较：一项随机试验
GlideRite® rigid stylet vs Flex-it® articulated stylet for intubation with videolaryngoscopy in patients with semi-rigid cervical collar: a randomized trial.
文献信息
| PMID | 42777818 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | John Viet Nguyen |
| 作者单位 | Université de Montréal, CIUSSS de l'Est-de-l'Ile de Montréal, Maisonneuve-Rosemont Hospital, Department of Anesthesiology and Pain Medicine, Montréal, QC, Canada. |
| 期刊 | Brazilian journal of anesthesiology (Elsevier) |
| SCI 分区 | Q2 |
| IF | 2.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 与GlideScope®高角度镜片配合使用的GlideRite®硬质管芯相比，Flex-it®管芯允许气管导管朝向声门动态调整方向。本随机试验比较了GlideRite和Flex-it管芯在佩戴半硬质颈托（模拟颈椎不稳定状况）患者中GlideScope插管持续时间。
方法： 80例接受择期手术的成年患者被随机分配至使用GlideScope配合GlideRite或Flex-it管芯进行气管插管。麻醉诱导后佩戴半硬质颈托。主要终点为插管持续时间（秒）。在我们的改良意向性治疗（mITT）分析中，插管失败被赋予最大持续时间180秒。次要结局包括气管导管操作持续时间、插管失败、插管困难量表和管芯移除难易度。
结果： 75例患者纳入mITT分析（Flex-it组n=38，GlideRite组n=37）。与GlideRite相比，使用Flex-it时插管持续时间更长（中位数[IQR]：88[65‒180] vs. 49[39‒61]秒），中位差异为37秒（95% CI：22至64；p < 0.0001）。Flex-it组导管操作持续时间更长（中位数[IQR]：48[33‒66] vs. 34[25‒39]秒；p = 0.007）。Flex-it组失败率显著更高（15/38，39.5%）高于GlideRite组（2/37，5.4%；p < 0.001）。Flex-it组插管困难量表评分更高（中位数[IQR]：6[5‒7] vs. 2[2‒5]；p < 0.001）。
结论： 在模拟颈椎不稳定的择期患者中，与GlideRite管芯相比，使用Flex-it管芯的视频喉镜插管导致插管时间更长、难度更大且失败率更高。
英文摘要
BACKGROUND: Compared with the GlideRite® rigid stylet used with the GlideScope® hyperangulated blade, the Flex-it® stylet permits dynamic orientation of the tracheal tube toward the glottis. This randomized trial compared GlideRite and Flex-it stylets regarding GlideScope intubation duration in patients wearing a semi-rigid cervical collar, simulating conditions of cervical instability.
METHODS: Eighty adult patients undergoing elective surgery were randomized to tracheal intubation using the GlideScope with either the GlideRite or the Flex-it stylet. A semi-rigid cervical collar was applied following anesthesia induction. The primary endpoint was intubation duration in seconds. For our modified Intention-To-Treat (mITT) analysis, failed intubations were assigned the maximum duration of 180 seconds. Secondary outcomes included tracheal tube handling duration, intubation failure, Intubation Difficulty Scale, and ease of stylet removal.
RESULTS: Seventy-five patients were included in the mITT analysis (n = 38 for Flex-it, 37 for GlideRite). Intubation duration was longer when using Flex-it compared with GlideRite (median [IQR]: 88 [65‒180] vs. 49 [39‒61]s) with a median difference of 37 s (95% CI: 22 to 64; p < 0.0001). Tube handling duration was longer with Flex-it (median [IQR]: 48 [33‒66] vs. 34 [25‒39]s; p = 0.007). Failure rate was significantly higher with Flex-it (15/38, 39.5%) than with GlideRite (2/37, 5.4%; p < 0.001. Intubation Difficulty Scale score was higher for Flex-it (median [IQR]: 6 [5‒7] vs. 2 [2‒5]; p < 0.001).
CONCLUSION: In elective patients with simulated cervical instability, videolaryngoscopy with the Flex-it stylet resulted in longer intubation, greater difficulty, and higher failure rate compared with the GlideRite stylet.