目的 比较Airtraq^®可视喉镜和Macintosh直接喉镜在慢诱导经口气管插管时的血流动力学反应。方法 选择50例行择期手术的需气管插管的全麻患者,随机分为Airtraq^®可视喉镜组(A组)和Macintosh直接喉镜组(M组),每组25例。所有患者均采用慢诱导,口咽部、舌根表面麻醉及环甲膜穿刺后分别使用Airtraq^®可视喉镜和Macintosh直接喉镜显露声门行气管插管。观察指标包括麻醉诱导前的基础值(T₁)、健忘镇痛慢诱导后3 min(T₂)、气管插管前(T₃)、气管插管即刻(T₄),以及气管插管后1(T₅)、3(T₆)、5 min(T₇)等时间点的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)及心率(HR);此外还有声门显露时间、插管总时间及麻醉过程中的不良反应。结果 与T₁时间点SBP值(127±15)mmHg相比,仅A组在给药后T₂点稍有下降(P<0.05),其余所有数值均较T₁无统计学差异; A组SBP值在T₂ [(73±9)mmHg]、T₃ [(75±8)mmHg]和T₅ [(80±13)mmHg]均高于M组,差异有统计学意义(P<0.05);在插管过程中,A组在各时点的MAP、HR与M组比较,差异无统计学意义。A组声门显露时间(8.0±2.2)s较M组(6.1±2.4)s长,但A组的插管总时间(15.9±4.4)s短于M组(19.7±3.8)s,上述差异均具有统计学意义(P<0.05);A组中有1例,M组中有3例轻度的呛咳反应。结论 与Macintosh传统喉镜相比,应用Airtraq^®可视喉镜行经口健忘镇痛慢诱导气管插管可减少插管时间,且血流动力学反应无明显差异。

Objective To compare the hemodynamic response to orotracheal intubation between using Airtraq^® laryngoscope and Macintosh laryngoscope during forgetfulness analgesia slow induction. Methods Fifty patients scheduled for surgery under general anesthesia requiring orotracheal intubation were randomly allocated to undergo intubation using Airtraq^® (group A, n=25) or Macintosh (group M, n=25). All subjects were orotracheally intubated after forgetfulness analgesia slow induction, which needed surface anesthesia of pharynx oralis and lingual root. The following data were recorded and analyzed: blood pressure (BP), mean arterial pressure (MAP) and heart rate (HR) before (T₁) and after (T₂) forgetfulness analgesia slow induction, before (T₃) and after (T₄) orotracheal intubation and thereafter at 1 (T₅), 3 (T₆) and 5 min (T₇),and glottis exposure time, tracheal intubation time, bucking occurrence. Results In comparison with T₁, only the SBP slightly declined after induction in group A [T₁ (127?15) mmHg, T₂ (116?8) mmHg]. In group A, the DBP at T₂ [(73?9) mmHg], T₃ [(75?8) mmHg] and T₅ [(80?13) mmHg] were higher than those in group M. The MAP and HR during the whole intubation procedure were higher in group A, but had no statistically significant difference. Group A had a long glottis exposure time [group A, (8.0?2.2) s, group M (6.1?2.4) s], but short tracheal intubation time [group A, (15.9?4.4) s, group M (19.7?3.8) s] compared with group M. The amount of bucking occurrence was 1 in group A and 3 in group M. Conclusions In comparison with the Macintosh laryngoscope, tracheal intubation using the Airtraq^® laryngoscope has a long glottis exposure time but short tracheal intubation time. And the hemodynamic response to orotracheal intubation between two laryngoscopes has no statistically significant difference during forgetfulness analgesia slow induction.