Lightwand光棒插管在整形外科手术中的应用

目的：观察1ightwand光棒用于整形外科手术患者常规气管插管的安全性，和有效性以及在预测困难气管插管的可行性。方法：选择152例ASA Ⅰ或IⅡ级全麻下行择期整形外科手术的患者，其中124例为正常气道，根据光棒前端弯曲角度不同随机分为A组（60°）和B组（90°），28例预测有困难气管插管为C组（90°）。记录各组插管时间、插管次数、插管的成功率、插管期间血流动力学变化以及术后并发症情况。结果：A、B和C组的一次插管成功率分别为100％、95．2％和85．7％，三组的插管总成功率均为100％；A、B和C组完成插管时间分别为（11．8±4．9）s、（14．0±5．4）S和（17．4±8．1）s，A组的光点寻找时间、光棒退出时间和气管插管时间均较B、C组缩短；光棒插管对循环功能的干扰小，术后并发症少。结论：lightwand光棒用于整形外科手术的常规气管插管及预测困难气管插管，插管成功率高、耗时短，对血流动力学影响较小，插管并发症少。

The application of lightwand intubation in plastic surgery

Objective To observe the safety and effectiveness of lightwand in routine endotracheal intubation for plastic operations and its feasibility to predict the difficult endotracheal intubation. Methods 152 ASA Ⅰ-Ⅱ patients scheduled for elective plastic surgery under general anesthesia were enrolled in this study. 124 amidst with normal airway were randomly divided into group A （60°） and group B（90°） according to the bent angle of the lightwand tip, and the other 28 predicted with difficult tracheal intubation were allocated into group C. The time and times of the tracheal intubation, and its succesuss ratio, together with the hemodynamic fluctuation and the complications arised during this period were recorded. Results The first-time intubation success rate of group A, B, and C was 100%,95.2%,85.7%respectively, while the total intubation success rate of all the three groups was 100%. The time used for a complete intubation in A, B, C was （11.8±4.9）s,（14.0±5.4）s,（17.4±8.1）s accordingly, from which, we can find that the time spent by group A is less than group B or C on light spot searching, lightwand withdrawing and trancheal intubating, and the interference of lightwand intubation against hemodynamic circulatory was slight and complications afterwards were low. Conclusion Featured with high success rate but short time consumption, lightwand can be used for routine tracheal intubation and prediction of difficult tracheal intubation in plastic operations for its slight influence to hemodynamics and few complications arised.