Hemodynamic Comparison of Different Laryngoscope Tracheal Intubation_West China Medical Journal

Authors：

LUuml ,  Peilin

Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, P.R.China;

Corresponding?author：

Peilin, Email: lppcd2007@yahoo.com.cn

Keywords：

全身麻醉; Shikani喉鏡; Macintosh直接喉鏡; GlideScope?視頻喉鏡; 血流動力學; 去甲腎上腺素

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【摘要】目的 比較靶控誘導后Shikani喉鏡、Macintosh直接喉鏡和GlideScope?視頻喉鏡插管時的應激反應。方法選取2008年12月-2009年2月期間ASA Ⅰ~Ⅱ級、擬于全身麻醉下行擇期顱內占位病變切除術的患者30例，隨機分為Shikani喉鏡組（S組）、Macintosh直接喉鏡組（M組）與GlideScope?視頻喉鏡組（G組）。靶控異丙酚和瑞芬太尼誘導，分別采用上述3種喉鏡行經口氣管插管。記錄患者的心率、血壓，計算心率收縮壓乘積（RPP）。結果 3組插管時間、心率、血壓和RPP比較差異無統計學意義（P gt;0.05）。S組和M組插管后心率、血壓及RPP均較插管前顯著升高（P lt;0.05），而G組插管后的心率、60~300 s時的收縮壓、平均動脈壓和RPP與插管前比較，差異無統計學意義（P gt;0.05）。結論 3種喉鏡進行經口氣管插管時具有相似的血流動力學反應，GlideScope?視頻喉鏡更有利于循環穩定。
【Abstract】 Objective To compare the hemodynamic responses of orotracheal intubations with GlideScope? videolaryngoscope, Macintosh direct laryngoscope, and Shikani optical stylet after target-controlled-infusion (TCI). Methods Thirty patients with American Society of Anesthesiologists (ASA) physical status Ⅰ-Ⅱ, scheduled for elective intracranial mass lesion surgery under general anesthesia were randomly allocated equally to Shikani optical stylet group (group S) Macintosh laryngoscope group (group M), and GlideScope? videolaryngoscope group (group G). After the patients became unconscious by TCI induction of propofpol and remifentanil, the endotracheal intubation were carried out through above three laryngoscope. The heart rate (HR), blood pressure and rate pressure product (RPP) were recorded. Results The differences of intubation time, HR, blood pressure and RPP in three groups were not statistically significant (P gt;0.05). After intubation, the HR, blood pressure and RPP of group S and M were obviously higher than those before intubation (P lt;0.05); while there was no obvious change on the HR, systolic pressure at 60-300 s, mean arterial pressure and RPP of group G compared before intubation (P gt;0.05). Conclusions There are similar hemodynamic responses in the three laryngoscope. GlideScope? is more advantageous to cycle stability.

Citation： LUuml,Peilin,LIU Bin. Hemodynamic Comparison of Different Laryngoscope Tracheal Intubation. West China Medical Journal, 2010, 25(8): 1505-1508. doi: Copy

1.	閆東來, 于泳浩, 劉宏偉. 可視可塑型硬光纖喉鏡在困難氣管插管中的應用[J]. 天津醫科大學學報, 2007, 13(4): 519-521.
2.	Agro F, Cataldo R, Carassiti M, et al. The seeing stylet: a new device for tracheal intubation[J]. Resuscitation, 2000, 44(3): 177-180.
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5.	李玄英, 薛富善, 孫莉, 等. GlideScope視頻喉鏡、直接喉鏡和光導纖維支氣管鏡經口氣管插管時血液動力學反應的比較[J]. 中華麻醉學雜志, 2006, 26(12): 1069-1073.
6.	吳濱陽, 陳杰, 王俊科. 不同效應室濃度瑞芬太尼靶控輸注時氣管插管誘發患者的心血管反應[J]. 中華麻醉學雜志, 2005, 25(12): 940-942.
7.	韓新生, 呂建瑞, 薛榮亮. 丙泊酚靶控輸注全麻誘導時機體應激反應的臨床研究[J]. 臨床麻醉學雜志, 2003, 19(6): 343-345.
8.	周少麗, 劉德昭, 寵紅宇, 等. 全麻誘導插管期間腦電雙頻指數和血液動力學變化的研究[J]. 臨床麻醉學雜志, 2004, 20(4): 207-209.
9.	Shribman AJ, Smith G, Achola KJ. Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation[J]. Br J Anaesth, 1987, 59(3): 295-299.
10.	Gobel FL, Nordstrom LA, Nelson RR, et al. The rate-pressure product as an index of myocardial oxygen consumption during exercise in patients with angina pectoris[J]. Circulation, 1978, 57: 549-556.
11.	Barak M, Ziser A, Greenberg A, et al. Hemodynamic and catecholamine response to tracheal intubation: direct laryngoscopy compared with fiberoptic intubation[J]. J Clin Anesth, 2003, 15(2): 132-136.
12.	宮煉, 周永蓮, 張雷波, 等. 光索導引經口氣管插管對循環和血漿去甲腎上腺素的影響[J]. 中國當代醫學, 2005, 4(17): 1-3.

1. 閆東來, 于泳浩, 劉宏偉. 可視可塑型硬光纖喉鏡在困難氣管插管中的應用[J]. 天津醫科大學學報, 2007, 13(4): 519-521.
2. Agro F, Cataldo R, Carassiti M, et al. The seeing stylet: a new device for tracheal intubation[J]. Resuscitation, 2000, 44(3): 177-180.
3. GlideScope Operator & Service Manual. Saturn Biomedical Systems Inc[S]. 2003.
4. 薛富善, 李玄英, 許亞超, 等. GlideScope視頻喉鏡不能減輕經口氣管插管的心血管反應[J]. 中國醫藥導刊, 2007, 9(1): 15-19.
5. 李玄英, 薛富善, 孫莉, 等. GlideScope視頻喉鏡、直接喉鏡和光導纖維支氣管鏡經口氣管插管時血液動力學反應的比較[J]. 中華麻醉學雜志, 2006, 26(12): 1069-1073.
6. 吳濱陽, 陳杰, 王俊科. 不同效應室濃度瑞芬太尼靶控輸注時氣管插管誘發患者的心血管反應[J]. 中華麻醉學雜志, 2005, 25(12): 940-942.
7. 韓新生, 呂建瑞, 薛榮亮. 丙泊酚靶控輸注全麻誘導時機體應激反應的臨床研究[J]. 臨床麻醉學雜志, 2003, 19(6): 343-345.
8. 周少麗, 劉德昭, 寵紅宇, 等. 全麻誘導插管期間腦電雙頻指數和血液動力學變化的研究[J]. 臨床麻醉學雜志, 2004, 20(4): 207-209.
9. Shribman AJ, Smith G, Achola KJ. Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation[J]. Br J Anaesth, 1987, 59(3): 295-299.
10. Gobel FL, Nordstrom LA, Nelson RR, et al. The rate-pressure product as an index of myocardial oxygen consumption during exercise in patients with angina pectoris[J]. Circulation, 1978, 57: 549-556.
11. Barak M, Ziser A, Greenberg A, et al. Hemodynamic and catecholamine response to tracheal intubation: direct laryngoscopy compared with fiberoptic intubation[J]. J Clin Anesth, 2003, 15(2): 132-136.
12. 宮煉, 周永蓮, 張雷波, 等. 光索導引經口氣管插管對循環和血漿去甲腎上腺素的影響[J]. 中國當代醫學, 2005, 4(17): 1-3.

West China Medical Journal

Hemodynamic Comparison of Different Laryngoscope Tracheal Intubation

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