侧卧位下应用插管喉罩行气管插管的可行性

目的紧急情况下侧卧位应用传统喉镜建立气道是很困难的。我们进行了一项随机对照试验,探讨在侧卧位下应用插管喉罩建立通气及其气管插管的成功率。方法 90例患者分为3组,每组30例,随机分为仰卧位,左侧卧位,右侧卧位。每组患者ASA分级为Ⅰ^Ⅱ级,择期在全身麻醉下行外科手术治疗,气道评估为非困难气道。诱导药物应用咪达唑仑、芬太尼、丙泊酚及阿曲库铵。诱导后置入插管喉罩,经插管喉罩盲探置入气管导管,分别记录成功率、所需时间以及需要调整的次数。数据采用卡方检验、方差分析及t检验。结果 3组患者插管成功率为100%,插管时间以及调整次数无显著性差异,P<0.05。结论侧卧位患者在紧急情况下需要建立气道,插管喉罩在可行性、插管成功率、所需时间方面有绝对的优势,是临床上最佳选择。

Feasibility Lateral Position Under Endotracheal Intubation Intubation Laryngeal Mask Line Application

Objective Airway in patients in the lateral position in emergency application of conventional laryngoscopy has always been proven to be difficult. We conducted a randomized controlled trial to explor the application and rate of ventilation and intubation in the lateral position via intubating laryngeal mask airway. Methods Ninety patients were divided into three groups of 30 patients each, positioned supine, right lateral, and left lateral randomly. Each group American Society of Anesth-esiologists grade Ⅰand Ⅱ, with normal airway posted for surgery under general anesthesia. Patients were induction withfentanyl, propofol and atrucrinium. ILMA was inserted andblind tracheal intubation via ILMA was done. The success rate, time taken and the number of adjusting maneuvers used for both procedures were recorded.The data was tabulated and analyzed using ANOVA（analysis of variance）, multiplttest and chisquare. Results The success rate of intubation（100%） and time taken in insertion and intubation was found to be quite similar in all the three groups. Conclusions We conclude that the ILMA has an important role to play in the emergency management of airways in patients in the lateral position in terms of ease, success rate and time taken.