视可尼可视喉镜与直接喉镜经口插管对血压和心率的影响

Impact of orotracheal intubation by Macintosh laryngoscopy versus Shikani optical stylet on blood pressure and heart rate

目的:比较使用Macintosh直接喉镜(MAC)和视可尼可视喉镜(SOS)经口气管插管的血流动力学变化。方法:40例择期神经外科手术患者随机分为MAC组和SOS组,每组20例。静脉诱导后分别采用MAC和SOS实施经口气管插管,记录两组患者在麻醉诱导前、开始插管、显露声门、插管完成即刻、插管后的SBP和HR的变化。结果:(1)插管时间:SOS组明显长于MAC组[(22±8)s vs.(17±8)s,P<0.05]。(2)SBP变化:两组患者SBP在开始插管时较麻醉诱导前均显著降低(P<0.05),插管后1、2 min时明显升高(P<0.05),插管后3、4、5 min时差异无显著性。(3)HR变化:两组患者插管后1、2 min时明显升高(P<0.05),插管后3、4、5 min时差异无显著性。结论 :采用MAC和SOS经口气管插管引起的心血管反应无明显差异。

Objective To compare the hemodynamic response to orotracheal intubation by Macintosh laryngoscopy （MAC） with Shikani optical stylet （SOS）. Methods Forty neurosurgical patients, ASA physical status Ⅰ-Ⅲ, were prospectively randomized to MAC group （n = 20） and SOS group （n = 20） according to the method of orotracheal intubation. Heart rate （HR） and invasive systolic blood pressure （SBP） were recorded at pre- and post-intubation. Results The intubation time was significantly longer in SOS group than in MAC group [（22 ±8） s vs. （17 ±8） s, P 〈 0.05]. SBP in both groups decreased significantly after induction （P 〈 0.05） and increased greatly at 1 and 2 min post-intubation （P 〈 0.05）, but did not differ at 3, 4 and 5 min. HR in both groups did not differ significantly between the SBP after induction. HR in both groups increased greatly at 1 and 2 min post-intubation （P 〈 0.05）, but did not differ markedly at 3, 4 and 5 rain after induction. There were no significant differences in the peak SBP and HR between the two groups. Conclusion MAC and SOS cause similar hemodynamie responses to orotracheal intubation.