超声引导环甲膜穿刺气道表麻对经鼻气管插管反应的影响

目的 探讨超声引导环甲膜穿刺气道表面麻醉对经鼻气管插管反应的影响.方法 择期行咽喉部手术患者60例, 随机分为超声组和盲探组 (n=30) .超声组在超声引导下环甲膜穿刺后注射2%利多卡因2 mL;盲探组以传统触诊法定位后穿刺注药.记录镇静时 (T0) 、穿刺注药后时 (T1) 、插管即刻 (T2) 、插管后2 min时 (T3) 、插管后5 min时 (T4) 的HR、MAP和心率收缩压乘积 (RPP) ;记录注药时呛咳评分、术后咽痛等并发症率.结果 与基础值比较, T1时2组MAP、HR和RPP升高 (P<0.05) ;与盲探组比较, 超声组各时点差异无统计学意义 (P>0.05) .与盲探组比较, 超声组穿刺时呛咳程度较轻、术后咽痛发生率降低 (P<0.05) .结论 超声引导环甲膜穿刺气道表麻对经鼻气管插管引起的插管反应与传统盲探法相似, 但相关并发症发生率较低.

Effect of Ultrasound-guided Cricothyroid Membrane Puncture Airway Surface Anesthesia on Nasotracheal Intubation Response

Objective To invastigate effect of ultrasound-guided cricothyroid membrane puncture airway surface anesthesia on nasotracheal intubation response.Methods Sixty patients undergoing elective pharyngeal throat surgery were randomly divided into ultrasound group and blind group (n=30) .Ultrasound group patients were given 2% lidocaine 2 m L by ultrasound-guided undergoing cricothyroid membrane puncture, while blind group patients were treated by traditional palpation method.HR, MAP and heart rate systolic pressure product (RPP) were recorded at sedative (T0) , after administrating (T1) , intubation immediately (T2) , 2 minutes after intubation (T3) , 5 minutes after intubation (T4) .Cough score and incidence of postoperative sore throat were recorded.Results HR, MAP and RPP of the two groups had no significant differences in the same time points (P>0.05) .Compared with the blind group, the degree of cough and incidence of postoperative sore throat were lighter in the ultrasound group (P<0.05) .Conclusion The effect of ultrasound-guided cricothyroid membrane puncture surface anesthesia on nasotracheal intubation response is similar to that of traditional palpation method, but the incidence of related complications is lower.