GlideScope视频喉镜与光导纤维支气管镜经口气管插管对血流动力学影响的比较

目的比较全身麻醉诱导后采用GlideScope视频喉镜(GSVL)和光导纤维支气管镜(FOB)经口气管插管对血流动力学的影响。方法施择期整形外科手术患者57例,随机分为GSVL组(n=29)和FOB组(n=28)。在常规静脉麻醉诱导后实施气管插管操作。监测麻醉诱导前、后,气管插管时和气管插管后1、2、3、4、5min的血压和心率变化。结果GSVL组与FOB组气管插管时间差异无显著性(P>0·05)。气管插管后两组患者的血压和心率均比麻醉诱导后明显升高,但血压最大值未超过麻醉诱导前水平,而心率最大值较麻醉诱导前显著升高。两组在观察期各对应时间点的血压和心率及血压和心率最大值差异均无显著性(P>0·05)。结论GSVL经口气管插管可引起与FOB经口气管插管相同程度的心血管系统应激反应。

Comparison of hemodynamic responses to orotracheal intubation between using GlideScope videolaryngoscope and fiberoptic bronchoscope

OBJECTIVE: To compare the hemodynamic responses to orotracheal intubation with GlideScope videolaryngoscope (GSVL) and with fiberoptic bronchoscope (FOB) after induction of general anesthesia. METHODS: Totally 57 ASA physical status I - II adult patients undergoing elective plastic surgery and requiring orotracheal intubation were randomly allocated to either GSVL group (n = 29) or FOB group (n = 28). After a routine intravenous anesthetic induction, orotracheal intubation was performed. Noninvasive blood pressure (BP) and heart rate (HR) were recorded before and after anesthetic induction, at intubation and thereafter at 1 minute interval for 5 minutes. RESULTS: The intubation time was not significantly different between the two groups (P > 0.05). After intubation, BP and HR exhibited significant increases compared to the post-induction values in both groups, but the maximum values of BP did not exceed the pre-induction values while the maximum value of HR was higher than the pre-induction value. During the observation, BP and HR at all time points as well as the maximum values of BP and HR had no significant differences between the two groups (P > 0.05). CONCLUSION: The orotracheal intubations using FOB and GSVL result in similar hemodynamic responses.