摘要
目的比较视频喉镜(GlideScope)和传统喉镜(Macintosh)及气管导管前端角度对模拟颈椎制动患者气管插管成功率和血流动力学的影响。方法选择ASAⅠ或Ⅱ级无颈椎活动异常或困难气道拟择期手术的成人患者80例,无长期服用影响BP、HR药物史。麻醉诱导前配戴颈托模拟颈椎制动。麻醉诱导后,随机均分为四组:G1组(弯曲60°)、G2组(弯曲90°)、M1组(弯曲60°)及M2组(弯曲90°),行气管插管。观察喉镜暴露(C/L)分级、插管难易程度[采用视觉模拟评分(VAS)]、插管时间、插管次数,记录基础值、麻醉诱导中、气管插管即刻、插管后1、3、5min时BP、HR变化。结果G1、G2组C/L分级优于M1、M2组(P<0.05),G1、G2组VAS低于M1、M2组,G2组插管时间短于其他三组(P<0.05)。四组各时点SBP、DBP、HR差异无统计学意义。结论使用GlideScope并将气管导管弯曲成90°有助于模拟颈椎制动患者的声门暴露,提高插管成功率。
Objective To evaluate the effect of cerve of GlideScope and tracheal tube intubation in patients with cervical spine immobilization. Methods Eighty adult patients, ASA class Ⅰ or Ⅱ , scheduled for selective surgery under general anesthesia were randomly allocated to four groups. GlideScope（GS） and endotraeheal tube （ETT） were curved at 60 degrees of angle in G1 group and at 90 degrees of angle in group G2. Macintosh laryngoscope（MS） and ETT were curved at 60 degrees of angle in group M1 and at 90 degrees of angle in group M2. The neck was immobilized with the special apparatus before anesthesia induction. The laryngeal view was estimated by Cormack-Lehane classification and the intubation time was assessed by ablinded observer. VAS was used to evaluate the response to intubation. BP and HR were recorded periintubation. Results The C/L grade was significantly better in group G1 and G2 than that in group M1 and M2 （P〈0. 05）. Intubation time was significantly shorter in group G2 than that in group G1. Intubation was easier in group G1 and G2 than that in group M1 and M2. There was no significant difference in hemodynamic response to intubation among the four groups. Conclusion Tracheal intubation with 90 degrees curved GS and ETT is better in providing good view and easy intubation in patients with cervical spine immobilization.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2009年第6期480-483,共4页
Journal of Clinical Anesthesiology
