视可尼可视喉镜用于鼾症患者慢诱导气管插管的临床观察

目的对视可尼引导气管插管操作方法在鼾症患者行腭咽成型术的可行性及安全性进行探讨和评价。方法 50例拟行全麻气管插管的鼾症患者,分为视可尼插管组(A组)、直接喉镜插管组(B组),每组25例,面罩吸氧,先用含1.5%丁卡因的喷壶2～3喷进行舌部和咽部表面麻醉,静脉注射咪唑安定2.0～2.5 mg,芬太尼2μg/kg,2 min后使用1.5%丁卡因3 ml进行环甲膜穿刺给药,表面麻醉充分后,Ramsay评分3分时,行气管插管。插管后用2 mg/kg异丙酚加深麻醉,肌松剂使肌肉松弛。观察记录插管次数、插管成功率、血流动力学改变及不良反应。结果与B组比较,A组插管时间明显较短,一次插管成功率和总插管成功率明显较高,插管次数明显较少,气管插管并发症发生率较低(P<0.05)。A组对血流动力学的改变与B组比较,差异有统计学意义(P<0.05)。结论视可尼引导气管插管技术可作为鼾症患者行腭咽成型术麻醉气管插管的一种有效方法。

Clinical study on Shikani optical style for endotracheal intubation after slow induction in patients with sleep apnea syndrome

Objective To explore and evaluate the feasibility and safety of endotracheal intubation（EI） guided by Shikani optical style（SOS） for uvulopalato-pharyngoplasty（UPPP） in patients with sleep apnea syndrome（SAS）.Methods Fifty patients with SAS performed UPPP under general anesthesia（GA） were randomly divided into group A（n = 25） and group B（n = 25）,patients in group A received EI guided by SOS and patients in group B received EI via direct laryngoscopy.All patients in two groups received oxygen uptake via a mask and the surface anesthesia（SA） on the tongue and pharynx with two or three sprays of 1.5% tetracaine.An injection of midazolam 2.0 ～ 2.5 mg and fentanyl 2 ？ g/kg was performed.Three milliliters of 1.5% tetracaine was administrated via thyrocricoid puncture at two minutes later.Endotracheal intubation was performed when surface anesthesia was sufficient and Ramsay scores were three.Propofol 2 mg / kg was used to deepen the level of anesthesia,and the muscle relaxant was used to relax muscles.Times of intubation（TI）,duration of intubation（DI）,successful rate（SR）,changes of hemodynamics（CH）,and side effects were observed.Results Duration of intubation in group A was significantly shorter than that of group B（P 0.05）.One-time successful rate and total successful rate of endotracheal intubation in group A were significantly higher than those of group B.Times of intubation and side effects were significantly fewer in group A than that of group B（P 0.05）.Changes in hemodynamics in group B was significantly larger than those of group A（P 0.05）.Conclusion Endotracheal intubation guided by Shikani optical style is an effective method for UPPP under general anesthesia in treatment of patients with sleep apnea syndrome.