Airtraq喉镜和Macintosh直接喉镜在经口气管插管时血流动力学的比较

目的比较Airtraq视频喉镜和Macintosh直接喉镜经口气管插管时心血管反应。方法40例拟择期经口气管插管全麻下手术的患者，按照随机数字表随机分为两组，Airtraq组（A组）和Macintosh喉镜组（M组），每组20例。观察麻醉诱导前、诱导后、插管即刻、插管后1、3min时的心率（HR）、血压和心率收缩压乘积（ratepressureproduct，RPP）。结果两组声门暴露时间差异无统计学意义（P〉0．05），导管置入时间A组（6±4）S短于M组（10±4）S（P〈0．01）。两组诱导后的HR、血压和RPP值都较诱导前的基础值明显下降（P〈0．05），插管即刻、插管后1min的心血管指标较诱导后明显增高（P〈0．05）。A组插管后3min心血管指标与诱导后比较差异无统计学意义（P〉0．05），而M组3min时心血管指标[收缩压（SBP）（106±17）mmHg（1mmHg=0．133kPa），舒张压（DBP）（65±10）mmHg，平均动脉压（MAP）（78±19）mmHg，HR（92±12）次／分，RPP（9748±2072）]与诱导后[SBP（93±15）mmHg，DBP（54±9）mmHg，MAP（67±10）mmHg，HR（85±12）次／分，RPP（8117±1886）]比较差异仍有统计学意义（R0．05）。A组、M组插管后5min心血管指标与诱导后比较差异均无统计学意义。结论与Macintosh直接喉镜相比，应用Airtraq视频喉镜行经口气管插管可减少插管置入时间，且血流动力学反应较轻。

Comparison of hemodynamic responses to orotracheal intubation between using Airtraq laryngoscope and Macintosh laryngoscope

Objective To compare the hemodynamic responses to orotracheal intubation between Airtraq laryngoscope and Macintosh laryngoscope. Methods 40 patients scheduled for surgery under general anesthesia requiring orotracheal intubation were randomly allocated to undergo intubation using Airtraq（group A, n=20） or Macintosh（group M, n=20） laryngoscope. The following data were recorded and analyzed： glottic exposure time, tracheal intubation time, blood pressure（BP） and heart rate（HR） before and after anesthetic induction, at intubation and thereafter at 1 and 3 min. The rate pressure product （RPP） at each measuring time point was calculated. Results There was no significant difference in the glottic exposure time between the two groups,but the intubation time in M group （10±4） s were significantly longer than that in A group （6±4） s. Compared with base value preinduction, BP, HR and RPP were significantly decreased in both groups.Glottic exposure and tracheal intubation caused significant increases in BP, HR, and RPP as compared with postinduction values. In group M, BP, HR and RPP at 3 min after indubation [SBP （106±17） mm Hg, DBP （65±10） mm Hg,MAP （78±19） mm Hg,HR （92±12） beat/min,RPP （9 748±2 072）]were significant higher than that with postinduction values [SBP （93±157 mm Hg,DBP（54±97 mm Hg,MAP（67±107 mm Hg,HR（85±127 beat/min,RPP（8 117±1 88673. But both A and M group, BP, HR and RPP at 5 rain after indubation were no significant with postinduction values. Conclusion In comparison to the Macintosh laryngoscope, tracheal intubation with the Airtraq laryngoscope resulted in less alterations in hemod＇cnamie resoonses.