Berman airway在经口纤维支气管镜气管插管中的临床应用

目的探讨应用Berman airway在经口纤维支气管镜引导气管插管中的安全性和有效性。方法ASAⅠ-Ⅱ级，年龄25—55岁择期行妇科腹腔镜手术的60例患者，随机分为两组行纤维支气管镜经口气管插管：A组辅用Berman airway（n=30），B组未辅用Berman airway法（n=30）。麻醉前进行气道评估分级（Ⅱ-Ⅲ级），并分别记录麻醉诱导前（T0），麻醉诱导后（T1），气管插管即刻（T2）及插管后1min（T3）、3min（T4）的收缩压（SBP）、心率（HR）以及声门暴露、送管、插管时间及相关并发症等。结果A组声门暴露、送管及插管时间均短于B组，差异具有统计学意义（P〈0．05）。血流动力学比较：组内比较，A组SBP、HR在各时间点均无统计学差异（P〉0．05），B组T2时间点SBP、HR较T1时升高（P〈0．05），与其它时间点比较无统计学差异（P〉0．05）。组间比较，B组他时SBP、HR均高于A组（P〈0．05），其余各时点比较两组间均无统计学差异（P〉0．05）。A组术后咽痛2例（6．7％），B组8例（26．7％），组间比较差异有统计学意义（P〈0．05）。结论纤维支气管镜经口气管插管中应用Berman airway，可缩短插管时的声门暴露时间及插管时间，使送管更加顺利，并提供更加稳定的血流动力学。

The Application of Berman Airway in the Fiberoptic Bronchoscope Guided Oral Endotracheal Intuba- tion

Objective To investigate the efficacy and safety of Berman airway application in the oral en- dotracheal intubation guided by fiberoptic bronchoscope. Methods A total of 60 patients with ASA Ⅰ to Ⅱ , aged from 25 to 55 years, were scheduled to gynecology laparoscopic operation under general anesthesia were enrolled and randomly divided into two groups, with 30 cases for each： group A was performed oral tracheal in- tubation assisted by Berman airway, and group B was performed oral tracheal intubation with elevation of the jaw. Hemodynamics parameter as systolic pressure （SBP） and heart rate （HR） were recorded before anesthe- sia（ T0）, after anesthesia induction（ T1 ）, immediate time point of catheterization（ T2）, and at the time point of 1 （ T3 ） and 3 minutes （T4） after tracheal intubation. While time of glottis exposure, tube delivery and cathe- terization time, intubation success rate and incidence of complications were compared. Results The time of glottis exposure, tube delivery and intubation were significantly shorter in group A than those in group B（P 〈0. 05）. There was no statistic difference in SPB and HR of group A among the different time points （ P 〉 0.05 ）, but there was obvious difference in SPB and HR between the time point of T2 and T1 of group B（P 〈 0.05 ）. Com- pared with group A, the SPB and HR of T2 was higher in group B （ P 〈 0.05 ）, but not statistic difference in other time points（P 〉0.05）. The post-operative pharyngalgia rate was 6.7% in group A, and was less than 26.7% in group B（P 〈 0.05 ）. Conclusion Application of Berman airway in oral tracheal catheterization under fiberoptic bronchoscope can shorten the time of glottis exposure and intubation, make the tube deliver easier and hemodynamics more stable.