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Shikani可视插管镜与Macintosh喉镜引起心血管反应比较

唐帅,  易杰,  黄宇光

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文章导航 > 协和医学杂志  > 2012 >  3(3): 314-317
唐帅, 易杰, 黄宇光. Shikani可视插管镜与Macintosh喉镜引起心血管反应比较[J]. 协和医学杂志, 2012, 3(3): 314-317. doi: 10.3969/j.issn.1674-9081.2012.03.015
引用本文: 唐帅, 易杰, 黄宇光. Shikani可视插管镜与Macintosh喉镜引起心血管反应比较[J]. 协和医学杂志, 2012, 3(3): 314-317. doi: 10.3969/j.issn.1674-9081.2012.03.015
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Shuai TANG, Jie YI, Yu-guang HUANG. Cardiovascular Responses of Intubation with Shikani Seeing Optical Stylet and Macintosh Laryngoscope[J]. Medical Journal of Peking Union Medical College Hospital, 2012, 3(3): 314-317. doi: 10.3969/j.issn.1674-9081.2012.03.015
Citation: Shuai TANG, Jie YI, Yu-guang HUANG. Cardiovascular Responses of Intubation with Shikani Seeing Optical Stylet and Macintosh Laryngoscope[J]. Medical Journal of Peking Union Medical College Hospital, 2012, 3(3): 314-317. doi: 10.3969/j.issn.1674-9081.2012.03.015
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Shikani可视插管镜与Macintosh喉镜引起心血管反应比较

doi: 10.3969/j.issn.1674-9081.2012.03.015

  • 中国医学科学院 北京协和医学院 北京协和医院麻醉科, 北京 100730

详细信息
    通讯作者:

    易杰 电话:010-69154278, E-mail:easyue@yahoo.com.cn

  • 中图分类号: R614.2+1

Cardiovascular Responses of Intubation with Shikani Seeing Optical Stylet and Macintosh Laryngoscope

  • Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

More Information

    摘要
  • 摘要:   目的  比较Shikani可视插管镜与Macintosh喉镜用于非困难气道患者的插管反应及插管并发症, 评价Shikani可视插管镜的临床应用价值和前景。  方法  将40例拟在气管插管全身麻醉下接受妇科腹腔镜或开腹手术的女性患者随机分为两组, 分别接受Shikani可视插管镜插管或Macintosh喉镜插管, 记录插管前后的平均动脉压、心率、气管导管误入食道的次数、插管时间和咽痛、声嘶的发生率。  结果  两组患者人口统计学指标差异无统计学意义。Shikani组插管前后平均动脉压分别为(69.0±6.7)和(86.0±11.6)mm Hg, 心率分别为(70.8±8.8)和(78.3±9.9)次/min。Macintosh组插管前后平均动脉压分别为(69.3±9.0)和(93.6±8.9)mm Hg, 心率分别为(71.2±12.5)和(87.6±13.5)次/min。两组插管后平均动脉压及心率与插管前比较差异均有统计学意义(P < 0.05), 但Shikani组波动更小(P < 0.05)。两组插管时间、咽痛、声嘶发生率比较差异均无统计学意义(P > 0.05)。  结论  应用Shikani可视插管镜进行气管插管引起的心血管反应小于Macintosh喉镜。
    Abstract:   Objective  To compare the cardiovascular responses and complications to tracheal intubation with Shikani seeing optical stylet or Macintosh laryngoscope in non-difficult airway patients and to assess the clinical values and prospects of Shikani seeing optical stylet.  Methods  Forty female patients scheduled for gynecological laparoscopy or laparotomy under general anesthesia were randomly assigned to Shikani group or Macintosh group. Their mean arterial blood pressure and heart rate before and after intubation, esophageal intubation, time needed for intubating, and incidence of sore throat and hoarseness were recorded.  Results  No significant difference was found on the demographic data between these two groups. In the Shikani group, the mean arterial blood pressure and heart rate were (69.0±6.7) mm Hg and (70.8±8.8) bpm before intubation and (86.0±11.6) mm Hg and (78.3±9.9) bpm after intubation. In the Macintosh group, the mean arterial blood pressure and heart rate were (69.3±9.0) mm Hg and (71.2±12.5) bpm before intubation and (93.6±8.9) mm Hg and (87.6±13.5) bpm after intubation. Both groups had significantly higher blood pressure and heart rate after intubation (P < 0.05), while such change was smaller in Shikani group (P < 0.05). No significant difference was found in terms of intubation time, incidences of sore throat and hoarseness (P > 0.05).  Conclusion  The cardiovascular response to Shikani seeing optical stylet is less severe than Macintosh laryngoscope.
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  • 表  1  气管插管期两组患者血流动力学变化(x ± s)

    气管插管期 平均动脉压(mm Hg) 心率(次/min)
    D组 L组 D组 L组
    入镜时 69. 3 ± 9. 0 69. 0 ± 6. 7 71. 2 ± 12. 5 70. 8 ± 8. 8
    出镜时 93. 6 ± 8. 9* 86. 0 ± 11. 6* ‡ 87. 6 ± 13. 5* 78. 3 ± 9. 9* ‡
    D组使用Macintosh喉镜，L组使用Shikani可视插管镜; 1 mm Hg = 0. 133 kPa; 与入镜时比较，* P＜0. 05;与D组比较，‡P＜0. 05
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    • 参考文献(9)
  • [1] Shikani AH. New "seeing" stylet-scope and method for the management of the difficult airway[J]. Otolaryngol Head Neck Surg, 1999, 120:113-116. doi:  10.1016/S0194-5998(99)70380-3
    [2] Rai MR, Dering A, Verghese C. The GlideScope system:a clinical assessment of performance[J]. Anaesthesia, 2005, 60:60-64. doi:  10.1111/j.1365-2044.2004.04013.x
    [3] Kovac LA. Controlling the hemodynamic response to laryngoscopy and endotracheal intubation[J]. J Clin Anesth, 1996, 8:63-79. doi:  10.1016/0952-8180(95)00147-6
    [4] Bishop MJ, Harrington RM, Tencer AF. Force applied during tracheal intubation[J]. Anesth Analg, 1992, 74:411-414. http://europepmc.org/abstract/MED/1539823
    [5] Fukuda T, Sugimoto Y, Yamashita S, et al. Forces applied to the maxillary incisors during tracheal intubation and dental injury risks of intubation by beginners:a manikin study[J]. Acta Anaesthesiol Taiwan, 2011, 49:12-15. doi:  10.1016/j.aat.2011.02.001
    [6] Lee RA, van Zundert AA, Maassen RL, et al. Forces applied to the maxillary incisors during video-assisted intubation[J]. Anesth Analg, 2009, 108:187-191. doi:  10.1213/ane.0b013e31818d1904
    [7] 赵诗斌, 贾乃光, 刘鲲鹏, 等. Shikani喉镜和Macintosh直接喉镜经口气管插管对血流动力学影响的比较[J].中国医学科学院学报, 2010, 32:303-309. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zgyxkxyxb201003014
    [8] Yao YT, Jia NG, Li CH. Comparison of endotracheal intubation with the Shikani optical stylet using the left molar approach and direct laryngoscopy[J]. Chin Med J, 2008, 121:1324-1327. doi:  10.1097/00029330-200807020-00015
    [9] Takahashi S, Mizutani T, Miyabe M, et al. Hemodynamic responses to tracheal intubation with laryngoscope versus lightwand intubating device (trachlight) in adults with normal airway[J]. Anesth Analg, 2002, 95:480-484. doi:  10.1213/00000539-200208000-00046
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出版历程
  • 收稿日期:  2010-07-27
  • 刊出日期:  2012-07-30

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