瑞芬太尼全麻诱导时视可尼喉镜与直接喉镜气管插管的临床观察

目的：观察瑞芬太尼全麻诱导时视可尼喉镜（shikaniopticalstylet，SOS屿直接喉镜气管插管对患者血流动力学变化的影响。方法：非心肺疾病择期手术患者60例，ASAI级，年龄20～40岁，体重40～60kg，随机分为视可尼喉镜组（S）组和直接喉镜组（H）组，每组30例。记录麻醉诱导前（T0）、气管插管前即刻（T1）、气管插管后1min（T2）、插管后2min（T3）及插管后3min（T4）的SBP、DBP、HR变化，记录插管试插例次，气管插管时间。术后随访气管插管的相关并发症。结果：两组均顺利完成气管内插管。S组平均插管时间为（36±12）s，H组平均插管时间为（20±8）s，两组插管时间差异有统计学意义（P〈0．05）。组内比较，与T0相比，两组T1SDB、DBP均明显下降（P〈0．05），两组HR无明显减慢（P〉0．05）；与T1相比，T2时两组SDB、DBP均明显升高（P〈0．05），两组HR无明显增快（P〉0．05）；与基础值T0相比，S组T2时SDB降低（P〈0．05），S组T2、T3、T4时HR增快（P〈0．05）。组间比较，两组血流动力学的改变，差异无统计学意义（P〉0．05）。S组有1例患者拔管后出现暂时性声音嘶哑，2例自诉咽喉疼痛，H组有2例患者诉咽喉疼痛，3例咽喉不适。结论：瑞芬太尼全麻诱导时，与直接喉镜相比，视可尼喉镜气管插管对患者血流动力学变化的影响无明显差异，可作为临床气管插管常规使用。

Remifentanil Anesthesia Induced Shikani Laryngoscope with Straight the Pick Laryngoscope Intubation Clinical Observation

objective： To observe the hemodynamic differences of patients to orotracheal intubation using a Shikani Optical Stylet （ SOS ） laryngoscope or a direct laryngoscope when remifentanil was applied in induction of general anesthesia.Method： 60 ASA grade I Patients （ femal ）, aged 20 to 40 years, weighing 40 to 60 kg scheduled for elective Gynecology perioneoscope surgical operations, were randomly divided into 2 groups. Group S （ n=30 ） ：using Shikani Optical Stylet （ SOS ）; group H （ n=30 ）： using direct laryngoscope. The following variables were recorded： SBP, DBP, HR at To （ before anesthetic induction ）, T1 （ immediately before intubation ） and 1 （ T2 ）, 2 （ T3 ）, 3 （ T4 ） minute after intubation. The attempt times , intubation time and complications were recorded. Result： The average time of intubation in two group were （ 36 ＋ 12 ） s, （ 20 ~ 8 ） s respectively, and the time in group H was significantly shorter than that in group S.At T1 compared to To, SDB and DBP decreased dramatically in both H group and S group（ P〈0.05 ）, but HR was not significantly different in two group （P〉0.05 ） ; At T2 compared to T1, Tracheal intubation caused significant increases in SBP and DBP in both H group and S group, but HR was not significantly different in two group （ P〉0.05 ） ; Compared with the basic values （ T0 ） in group S , SDB at T2 was lower （ P〈0.05 ）, and HR in 1, 2, 3 minute after intubation was all increased significantly （ P〈0.05 ） . the hemodynamic differences of patients to orotracheal intubation in both H group and S group was not significantly different （P〉0.05） .Conclusion： The hemodynamic responses of patients to orotracheal intubation using a Shikani Optical Stylet （ SOS ） laryngoscope is not significantly different from those using a direct laryngoscope.