全麻患者经Cookgas气管插管型喉罩盲探气管插管的可行性

Blind intubation via Cookgas intubating laryngeal airway in patients under general anesthesia

目的评价全麻患者经Cookgas气管插管型喉罩(CILA)盲探气管插管的可行性。方法择期在全麻下行整形外科手术患者60例,随机分为2组(n=30):盲探组与纤维支气管镜引导组 (FOB组)。麻醉诱导后,两组均先置入CILA,盲探组经CILA盲探气管插管,FOB组经CILA用FOB引导气管插管,记录两组经CILA气管插管的时间及成功率。结果 60例患者均成功置入CILA,与FOB 组比较,盲探组气管插管时间延长(P<0．05),气管插管成功率差异无统计学意义(P>0．05)。结论经CILA盲探气管插管是可行的。

Objective To evaluate the feasibility of bhnd intubation via Cookgas intubating laryngeal airway （CILA） in patients under general anesthesia. Methods Sixty ASA Ⅰ or Ⅱ patients aged 11-65 yrs scheduled for elective plastic surgery under general anesthesia were randomly allocated into 2 groups （ n = 30 each） ： blind intubation group （B） and fiberoptic bronchoscope group （FOB）. All patients were evaluated before operation to identify patients with difficult airway. Anesthesia was induced with midazolam 0.05mg·kg^-1, fentanyl 2 μg·kg^-1, propofol 2 mg·kg^-1 and vecuronium 0.1mg·kg^-1. CILA was inserted in all patients. The patients in group B were bhndly intubated via CILA, while in group FOB tracheal intubation was guided with fiberoptic bronchoscope via CILA. The time spent in intubation and the success rate of tracheal intubation were recorded. SBP, DBP, HR and SpO2 were recorded immediately before and after induction of anesthesia, immediately after insertion of CILA, immediately after tracheal intubation and immediately after CILA was withdrawn. Results CILA was inserted successfully in all patients. In group B tracheal intubation was accomplished at first attempt in 26 patients, at 2nd or 3rd attempt in 2 patients and failed in 2 patients. In group FOB tracheal intubation was much easier and accomplished at 1st attempt in 29 patients and at 2nd attempt in 1 patient. Twenty four of 25 patients expected to be difficult intubation were intubated successfully. The two groups were comparable with respect to hemodynamic changes during intubation. Conclusion It is possible to intubate via CILA. The success rate is high with minimal cardiovascular response.