不同喉镜气管插管时的血流动力学比较

【】目的比较靶控诱导后Shikani喉镜、Macintosh直接喉镜和GlideScope?视频喉镜插管时的应激反应。方法选取2008年12月-2009年2月期间ASAⅠ~Ⅱ级、拟于全身麻醉下行择期颅内占位病变切除术的患者30例，随机分为Shikani喉镜组（S组）、Macintosh直接喉镜组（M组）与GlideScope?视频喉镜组（G组）。靶控异丙酚和瑞芬太尼诱导，分别采用上述3种喉镜行经口气管插管。记录患者的心率、血压，计算心率收缩压乘积（RPP）。结果3组插管时间、心率、血压和RPP比较差异无统计学意义（P>0.05）。S组和M组插管后心率、血压及RPP均较插管前显著升高（P0.05）。结论3种喉镜进行经口气管插管时具有相似的血流动力学反应，GlideScope?视频喉镜更有利于循环稳定。【Abstract】ObjectiveTocomparethehemodynamicresponsesoforotrachealintubationswithGlideScope?videolaryngoscope,Macintoshdirectlaryngoscope,andShikaniopticalstyletaftertarget-controlled-infusion(TCI).MethodsThirtypatientswithAmericanSocietyofAnesthesiologists(ASA)physicalstatusⅠ-Ⅱ,scheduledforelectiveintracranialmasslesionsurgeryundergeneralanesthesiawererandomlyallocatedequallytoShikaniopticalstyletgroup(groupS)Macintoshlaryngoscopegroup(groupM),andGlideScope?videolaryngoscopegroup(groupG).AfterthepatientsbecameunconsciousbyTCIinductionofpropofpolandremifentanil,theendotrachealintubationwerecarriedoutthroughabovethreelaryngoscope.Theheartrate(HR),bloodpressureandratepressureproduct(RPP)wererecorded.ResultsThedifferencesofintubationtime,HR,bloodpressureandRPPinthreegroupswerenotstatisticallysignificant(P>0.05).Afterintubation,theHR,bloodpressureandRPPofgroupSandMwereobviouslyhigherthanthosebeforeintubation(P0.05).ConclusionsTherearesimilarhemodynamicresponsesinthethreelaryngoscope.GlideScope?ismoreadvantageoustocyclestability.？