全身麻醉诱导后经多功能插管型喉罩盲探气管插管的临床观察

Application of blind orotracheal intubation via BlockBuster laryngeal mask in patients undergoing general anesthesia

目的观察全身麻醉患者经多功能插管型喉罩盲探行气管插管的可行性及安全性。方法选择ASA分级I、Ⅱ级，年龄18-77岁择期行全身麻醉下手术的患者100例。麻醉诱导使用芬太尼4μg／kg、丙泊酚1．5-2．0mg／kg、罗库溴铵0．6ms／ks，诱导后先置入多功能插管型喉罩，通气行纤维支气管镜检查并定位后，经喉罩盲探插入配套的鹰嘴气管导管，观察放置喉罩及气管插管的次数和时间，记录诱导前、放置喉罩前后、气管插管前后的BP和HR。结果置入喉罩和气管插管均1。2次成功，置入喉罩时间平均（11．O±3．2）s，气管插管时间平均（10．5±6．2）s，插管成功退出喉罩后即刻SBP、DBP和HR与诱导前比较，差异均无统计学意义（P〉O．05）。结论经多功能插管型喉罩盲探气管插管，安全、快捷、有效，患者舒适、刺激小，比经典的插管型喉罩盲探插管更具有优势。

Objective To investigate the safety and efficacy of blind orotracheal intubation via BlockBuster laryngeal mask. Methods One hundred patients, ASA Ⅰ or Ⅱ, between 18 and 77 years old were enrolled in this study. General anesthesia was induced with fentanyl 4 μg/kg i.v, propofol 1.5-2.0 mg/kg i.v and rocuronium 0.6 mg/kg i.v. An effective mask ventilation was performed. The BlockBuster laryngeal mask was gradually introduced into position, the cuff was inflated with air and the ability to ventilate was confirmed. A fiberoptic scope was then inserted through the airway to grade the scoring of the glottis view. Making sure the fiberoptic scoring was less than 2. Then, patients were intubated blindly through the BlockBuster laryngeal mask. The number of adjusting manoeuvres, time to intubation, intubation success rates, haemodynamic changes （pre-induction, pre-intubation, postintubation）, oesophageal intubation, mucosal trauma （blood detected）, hypoxia （oxygen saturation 〈95% ） and postoperative pharyngolaryngeal morbidity （double-blinded） were documented. Results All one hundred patients were intubated in one or two attempts. Time to successful BlockBuster laryngeal mask insertion was （11.0±3.2） s, Time to successful intubation was （10.5±6.2） s. There were no significant differences in blood pressure or heart rate among the groups at any time. Conclusions Blind intubation through the BlockBuster laryngeal mask has many advantages, safe and quickly, effective and comfortable. It＇s a better choice in the difficult airway management,