GlideScope视频喉镜、直接喉镜和光导纤维支气管镜经口气管插管时血液动力学反应的比较

被引：31

作者：

李玄英 ^{[1
]}

薛富善 ^{[1
]}

孙莉 ^{[2
]}

张国华 ^{[1
]}

孙海涛 ^{[1
]}

李成文 ^{[1
]}

刘鲲鹏 ^{[1
]}

机构：

[1] 中国医学科学院中国协和医科大学整形外科医院麻醉科

[2] 中国医学科学院中国协和医科大学肿瘤医院麻醉科

来源：

中华麻醉学杂志 | 2006年 / 12期

关键词：

喉镜检查; 支气管镜检查; 插管法,气管内; 血液动力学现象;

D O I：

暂无

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

目的比较正常气道患者GlideScope视频喉镜(GSVL)、Macintosh直接喉镜(MDLS)和光导纤维支气管镜(FOB)经口气管插管时的血液动力学反应。方法拟在经口气管插管全身麻醉下行择期整形外科手术的患者60例,ASAⅠ或Ⅱ级,年龄18-50岁,随机分为3组(n=20):GSVL组、MDLS组和FOB组。常规麻醉诱导后,分别采用GSVL、MDLS或FOB实施经口气管插管,记录麻醉诱导前(基础值)、气管插管前即刻、气管插管后即刻及插管后1、2、3、4、5min血压(BP)和心率(HR),并记录整个观察期BP和HR的最大值。计算各观察时点的收缩压×心率乘积(RPP)。以时间为横坐标、观察期BP和HR为纵坐标计算血液动力学时-效关系曲线下面积。结果与MDLS组相比,FOB组气管插管时间延长(P<0.05),气管插管后即刻HR和RPP升高(P<0.05),GSVL组各指标差异无统计学意义;与GSVL组相比,FOB组各指标差异无统计学意义;3组血液动力学时-效关系曲线下面积差异均无统计学意义。结论与MDLS和FOB相比,采用GSVL在预防正常气道患者经口气管插管时血液动力学反应方面并无明显优势,但FOB引导经口气管插管时所致的血液动力学反应却强于MDLS。

引用

页码：1069 / 1073

页数：5

共 9 条

[1]

Cardiovascular and catecholaraine responses to laryngoscopy with and without tracheal intubation. Shribman AJ,Smith G,Achola KJ. British Journal of Anaesthesia . 1987

[2]

Use of a new videolaryngoscope ( Glide Scope) in the management of a difficult airway. Cooper RM. Canadian Journal of Anaesthesia . 2003

[3]

Fentanyl attenuates the hem-odynamic response to endotracheal intubation more than the response to laryngoscopy. Adachi YU,Satomoto MS,Higuchi H,et al. Anesthesia and Analgesia . 2002

[4]

Early clinical experience with a new videolaryngoscope (GlideScope) in 728 patients. Cooper RM,Pacey JA,Bishop MJ.et al. Canadian Journal of Anaesthesia . 2005

[5]

Effects of lightwand (Trachlight)compared with direct laryngoscopy on circulatory responses to tracheal intubation. Hirabayashi Y,Hiruta M,Kawakami T, et al. British Journal of Anaesthesia . 1998

[6]

Tracheal intubation using a Macintosh laryngoscope or a GlideScope in 15 patients with cervical spine immobilization. Agro F,Barzoi G,Montecchia F. British Journal of Anaesthesia . 2003

[7]

Awake intubation using the GlideScope video laryngoscope: initial experience in four cases. Doyle DJ. Canadian Journal of Anaesthesia . 2004

[8]

Effect of fentanyl on the circulatory responses to orotracheal fibreoptic intubation. Smith JE,King MJ,Yanny HF, et al. Anaesthesia . 1992

[9]

Ease of intubation with the GlideScope or Macintosh laryngoscope by inexperienced operators in simulated difficult airways. Lim Y,Lim TJ,Liu EH. Canadian Journal of Anaesthesia . 2004

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