摘要
目的比较Airtraq与GlideScope视频喉镜与普通Macintosh直接喉镜在颈椎制动患者全麻气管插管中的应用效果以及对血流动力学的影响。方法择期在气管插管全麻下的手术患者90例,ASAⅠ或Ⅱ级,年龄18～60岁,随机均分为Airtraq视频喉镜组(A组)、GlideScope视频喉镜(G组)和Macintosh直接喉镜组(M组)。麻醉诱导后,采用手法控制稳定方法制动头颈部,分别使用Airtraq视频喉镜、G1ideScope视频喉镜、Macintosh直接喉镜经口插管。记录三组声门暴露时间、导管置入时间、试插次数、失败例数、有无助手辅助、镜下Cormark-Lehane(C-L)分级,记录插管前、插管后即刻、插管后1、2、3min的MAP和HR及不良反应。结果 A组声门暴露时间明显长于M组(P<0.05);A组和G组的导管置入时间明显短于M组(P<0.05),G组的插管总时间明显短于M组(P<0.05)。A、G两组需要助手辅助比例、插管失败率及并发症发生率均明显低于M组,C-L分级Ⅰ级患者例数明显多于、Ⅲ级患者例数明显少于M组(P<0.05)。M组插管后即刻和插管后1minMAP明显高于、HR明显快于插管前(P<0.05)。插管后各时点M组HR均明显快于A组和G组(P<0.05)。结论与Macintosh直接喉镜比较,Airtraq和G1ideScope视频喉镜在颈椎制动患者气管插管中声门暴露良好,降低了插管难度,提高了插管成功率。
Objective To compare the use of the GlideScope, Airtraq and the conventional Macintosh laryngoscope in simulated cervical spine immobilization. Methods Ninety ASA I or lI patients, between 18 and 60 years old, undergoing general anesthesia were randomly assigned to receive intubation using Airtraq （group A）, GlideScope （group G） or Macintosh （group M） laryngoscope with each 30. Each patient was provided manual in-line axial stabilization of the head and neck by an experienced assistant. The following data were recorded and analyzed： glottic exposure time, tracheal intubation time, Cormark-I.ehane grade, manoeuvre needed to aid tracheal intubation, intubation attempts, failure for tracheal intubation, MAP, HR and complications before and the moment,l,2,3 min after intubation. Results Compared with group M, the glottic exposure time in group A was longer （P〈0. 05）, but the tracheal intuhation time was shorter in groups A and G （P 〈0.05）, total duration of intubation was shorter in group G （P〈0. 05）. More assistance was need and the intubation failure and complication rate was higher in group M（P〈0. 05）. Patients who were C-L grade I in groups A and G were more than that in group M. Compared with before intubation, MAP and HR in group M were increased than the moment and 1 min after intubation（P〈0. 05） and HR were faster that in other two groups after intubation （P＊〈 0. 05）. Conclusion The Airtraq laryngoscope and GlideScope are good alternatives for tracheal intuhation in patients with cervical spine immobilization with better glottic exposure and less intubation failure.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2013年第2期137-140,共4页
Journal of Clinical Anesthesiology
