视频气道表面麻醉喷雾装置在清醒困难气管插管中的应用

Application of video surface anesthesia spray device during oral tracheal intubation in conscious patients with difficult airway

目的探讨帝视观察用内窥镜(DS)组装Madgic?喉麻喷雾装置在困难气道患者清醒气管插管中的应用效果。方法头颈部烧伤后严重瘢痕增生、挛缩的患者80例随机均分为四组,插管前的咽喉表面麻醉(表麻)分别采用Madgic?喉麻管(M组)、DS组装Madgic?喉麻喷雾装置(DM组)、7%利多卡因气雾剂(L组)和DS组装7%利多卡因气雾剂(DL组)。比较插管条件、插管时间、插管次数和患者对插管过程的耐受程度,记录插管期间HR、MAP、SpO2变化,计算表麻用药量。结果 DM组与DL组气道准备条件的评分、一次插管成功率、单次成功插管时间和患者耐受程度的评分均优于M组与L组(P<0.05)。DM组与DL组插管过程中的HR和MAP均低于M组与L组(P<0.05)。DL组利多卡因使用量少于DM组(P<0.05)。结论 DS组装Madgic?喉麻喷雾装置能准确朝向靶点喷雾,临床效果显著超过盲探喷雾操作。

Objective To evaluate the clinical efficience of video surface anesthesia spray device （DM） in awake patients with difficult airway. Methods Eighty patients with cicatricial hypertrophy and contraction after severe facial and head burns were randomly and equally divided into four groups. The laryngotracheal surface spray before intubation was performed with Madgic （group M）, Disposcope combined with Madgic （group DM）, 7% lidocaine aerosol （group L） and Disposcope combined with lidocaine aerosol spray（group DL）, respectively. The intubation condition, success rate at first attempt, the time for intubation, and HR and MAP during intubation were recorded. Results The intubation condition score, intubation success rate at first attempt, successful intubation time and tolerance score of patients to intubation were higher in groups of DM and DL than those in groups of M and L（P〈0. 05）. The levels of HR and MAP during intubation were lower in groups of DM and DL than those in groups of M and L（P〈0. 05）. The consumption of lidocaine was less in group DL than that in group DM （P〈0. 05）. Conclusion The laryngotracheal surface spray with DM can accurately conduct airway surface anesthesia towards the target area with better efficacy in awake patients with difficult airway.