光棒、标准喉罩和普通喉镜在全身麻醉中应用的比较

A comparison of application of the Light wand, Laryngeal Mask Airway and direct laryngoscope during general anesthesia

目的将光棒、标准喉罩和普通喉镜应用于全麻患者，并对其临床效果及安全性进行比较和评价。方法120例ASAI～Ⅱ级，拟行全身麻醉患者，随机分为光棒组（A组，n=40）、喉罩组（B组，n=40）和喉镜组（C组，n=40），于常规静脉麻醉诱导后分别进行光棒引导气管插管，标准喉罩置人，普通喉镜气管插管。观察记录诱导前，诱导后，插管（喉罩）后1、3、5min时患者血压和心率，以及3组插管时间、插管成功率及插管后并发症。结果3组插管成功率之间差异无统计学意义（P〉0．05）。A组插管时间明显低于其他2组（P〈0．05）；B组和C组之间差异元统计学意义（P〉0．05）。C组对患者血流动力学影响明显高于其他2组（p〈0．05）。不良反应方面：C组术后咽喉疼痛的发生高于A组和B组（P〈0．05），A组和B组之间差异无统计学意义（P〉0．05）。结论光棒插管技术操作简便实用，容易掌握，并发症少，成功率高，是麻醉医师进行全身麻醉操作的较理想选择。

Objective To compare and evaluate the efficacy and safety during general anesthesia with Light wand, Laryngeal Mask Airway and the direct laryngoscope. Methods 120 patients, ASA I - II , undergoing elective surgery under general anesthesia were randomly allocated to one of the three groups ： Laryngeal Mask Airway group （ group A, n =40） , Light wand group （group B, n =40） and the direct laryngoscope group （ group C, n =40）. A standardized an- esthetic technique was used. The patients were inserted orally using each equipment after induction of general anesthesia. Heart rate and blood pressure were recorded before induction, after induction but before insertion, and at 1 min, 3 min, and5 min after insertion. The insertion time, the success rate of insertion at first attempt, the injuries and the incidence of airway complications of all groups were also observed. Results There were no statistical differences found in the success rate of insertion between all the three groups （ P 〉 0.05 ）. The time of insertion of group A was significantly shorter than that of group C and group B （ P 〈0. 05 ）. There were no statistical differences in time of insertion between group B and group C （ P 〉 0.05 ）. The changes of hemodynamic parameters in group C was more significant than that in group A and group B （ P 〈 0.05 ）. The injuries and the incidence of airway complications were also higher in group C than in group A and group B （ P 〈 0.05 ） , there were no statistical differences between group A and group B （ P 〉 0.05 ）. Conclusions Compared with the direct laryngoscope and Laryngeal Mask Airway, general anesthesia using Light wand is more successful, safer, valid and less injurious.