氣道處理長久以來都是非常重要的臨床醫療議題。在眾多方法中，氣管插管是最安全有效的呼吸道處理方式。舉凡臨床麻醉、心肺復甦急救、與加護病房都常需為病患進行氣管插管。自從1890年代以來，傳統硬式喉頭鏡即為臨床上進行氣管插管的主要工具，然而由於傳統硬式喉頭鏡構造上的限制，困難插管與其相關併發症，如：牙齒傷害，一直都是臨床上威脅病患安全的重要問題。根據美國麻醉醫學會統計：與氣道處理相關的麻醉醫療糾紛中，超過一半是牙齒傷害。而插管傷害牙齒的危險因子包括：病患牙齒鬆動、緊急插管、困難插管、與插管者技術不純熟…等，其中插管者的經驗與技術，是除了病患本身條件以外的主要影響因子。此外，插管工具的選擇，也被一些文獻認為與牙齒傷害相關。本研究的目的為建立一個假體插管評估系統，以進行一新式阻力回饋型喉頭鏡與傳統喉頭鏡在操作插管時的力學分析，並比較插管經驗在使用不同喉頭鏡時所造成的影響。
本研究透過42位不同經驗之插管者比較傳統Macintosh喉頭鏡及新式阻力回饋型喉頭鏡在假人上插管的力學分析。研究方法為分別在傳統Macintosh喉頭鏡及新式阻力回饋型喉頭鏡的握把處黏貼應變規，以量測挑管時的形變，測量前給予靜止的喉頭鏡掛砝碼並施以50牛頓重量執行校正，而插管假體的上顎後端裝置荷重元以量測牙齒受壓迫力量，測量前於荷重元施以50牛頓重量作為校正，並以眼鏡型針孔攝影機拍攝最佳喉頭視野，挑管過程為將喉頭鏡放入假體口中，當受測者挑管看到最佳的喉頭視野時，給予拍照，並放入管子，將喉頭鏡拿出後為完成挑管過程。主要研究目標為比較兩種喉頭鏡挑管過程中喉頭的受力、喉頭鏡的拉力、牙齒的受力、插管時間、與最佳喉頭視野之差異，並比較不同經驗的插管者，使用兩種不同喉頭鏡之表現。而統計方法，在喉頭鏡與不同經驗的受測者比較採用t-test，傳統Macintosh喉頭鏡與不同波型的比較採用t-test，新式阻力回饋型喉頭鏡與不同波型的比較採用ANOVA，不同經驗的受測者與波型的比較採用Chi-square。
本研究結果顯示無論插管者的經驗多寡，使用傳統Macintosh喉頭鏡，喉頭的受力為，有經驗者: 25.18N vs 16.76N，無統計上差異；無經驗者：25.79N vs 21.76N，無統計上差異、喉頭鏡的拉力為，有經驗者: 15.17N vs 10.96N(p<0.05)；無經驗者：15.35N vs 14.72N，無統計上差異、牙齒受力為，有經驗者：9.82N vs 5.8N(p<0.05)、無經驗者：10.61N vs 7.04N (p<0.05)，傳統傳統Macintosh喉頭鏡量測值皆大於使用阻力回饋型喉頭鏡。而插管經驗少的受測者無論使用傳統Macintosh喉頭鏡或阻力回饋型喉頭鏡，喉頭的受力為，使用傳統Macintosh喉頭鏡：25.79N vs 25.18N，無統計上差異、使用阻力回饋型喉頭鏡：21.76N vs 16.76N，無統計上差異、喉頭鏡的拉力，使用傳統Macintosh喉頭鏡：15.35N vs 15.17N，無統計上差異、使用阻力回饋型喉頭鏡：14.72N vs 10.96N，無統計上差異、牙齒受力為，使用傳統Macintosh喉頭鏡：10.61N vs 9.82N，無統計上差異、使用阻力回饋型喉頭鏡：7.04N vs 5.8N (p<0.05)，插管經驗少的受測者量測值皆大於插管經驗多的受測者。而最佳喉頭視野，無論使用何種挑管工具及受測者的經驗多寡，挑管視野皆為最佳部分，挑管評分指數為三分。
本研究的結果顯示不論插管者經驗多寡，使用阻力回饋型喉頭鏡於插管時的力學分析都比使用傳統Macintosh喉頭鏡有較佳的效果表現；而插管經驗較多者則在使用阻力回饋型喉頭鏡有較佳的效果表現。本研究的結論為新式阻力回饋型喉頭鏡於挑管時可達省力的效果，且對牙齒造成的傷害較小。

Airway management is a very critical issue for life saving in clinical practice. Tracheal intubation (TI) has been the most safe and effective technique among the methods of airway management. Patients undergoing general anesthesia, cardiopulmonary resuscitation and admission of intensive care unit, are often required TI. Since the 1890s, the conventional rigid laryngoscope has been the most popular tool applied in clinical TI. However, the conventional rigid laryngoscopes have limitation of structure, such as difficult intubation and its complications, for example dental injury, has been effect patients safety in clinical. According to the American Society of Anesthesiologists Statistics：medical disputes about airway management and anesthesia is more than half of dental injury. While intubation risk factors for dental injury include：loose teeth of patients, emergency intubation, difficult intubation, and intubation technique ... etc. And, the major effect factor in intubation is persons experience and technique. The choice of intubation instruments is also considered a associated factor of dental trauma in some previous studies. The purpose of this study is the operational performance evaluation of a new laryngoscope, and established an evaluation system for manikin intubation and compares the operational performance of traditional laryngoscope and new laryngoscope. And compare the subject’s experience.
In this study, we compare the biomechanical and clinical effects of the conventional Macintosh laryngoscope (CML) and resistance feedback laryngoscope (RFL) in TI in intubators with different level of intubation experience. Strain gauges are stick on grip of Macintosh laryngoscope and resistance feedback laryngoscope (RFL), to measure the strain of intubation process. Also, the manikin upper palate is installing a load cell to measure the compression of dental. (Descript the procedure of this study……..As well as, the best vocal view is photograph by the video camera glasses). The primary outcomes of this study include comparison of CML and RFL in the force of intubation process about compression of vocal, pull of laryngoscopes, compression of dental, the best vocal view, and the intubation time. The statistics are: T-test between laryngoscope and different groups, ANOVA between laryngoscope (Macintosh) and pattern, T-test between laryngoscope (RFL) and pattern, Chi-square between different groups with pattern.
The results showed that whatever the subjects experience, the measure data of use Macintosh laryngoscope are greater than resistance feedback laryngoscope (RFL)：the compression of vocal(25.18 N vs 16.76 N；25.79 N vs 21.76 N), the pull of laryngoscope(15.17 N vs 10.96 N、15.35 N vs 14.72 N), the compression of dental(9.82 N vs 5.8 N、10.61 N vs 7.04 N). While the inexperienced subjects use tools whatever Macintosh laryngoscope or resistance feedback laryngoscope(RFL), the measure data are larger than experiences subjects：the compression of vocal(25.79 N vs 25.18 N、21.76 N vs 16.76 N), the pull of laryngoscope (15.35 N vs 15.17 N、14.72 N vs 10.96 N). And the intubation views are almost excellent; the intubation conditions score are three.

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