【摘要】 目的  比较靶控诱导后Shikani喉镜、Macintosh直接喉镜和GlideScope®视频喉镜插管时的应激反应。 方法  选取2008年12月-2009年2月期间ASA Ⅰ~Ⅱ级、拟于全身麻醉下行择期颅内占位病变切除术的患者30例，随机分为Shikani喉镜组（S组）、Macintosh直接喉镜组（M组）与GlideScope®视频喉镜组（G组）。靶控异丙酚和瑞芬太尼诱导，分别采用上述3种喉镜行经口气管插管。记录患者的心率、血压，计算心率收缩压乘积（RPP）。 结果  3组插管时间、心率、血压和RPP比较差异无统计学意义（P gt;0.05）。S组和M组插管后心率、血压及RPP均较插管前显著升高（P lt;0.05），而G组插管后的心率、60~300 s时的收缩压、平均动脉压和RPP与插管前比较，差异无统计学意义（P gt;0.05）。 结论  3种喉镜进行经口气管插管时具有相似的血流动力学反应，GlideScope®视频喉镜更有利于循环稳定。
【Abstract】 Objective  To compare the hemodynamic responses of orotracheal intubations with GlideScope® videolaryngoscope, Macintosh direct laryngoscope, and Shikani optical stylet after target-controlled-infusion (TCI). Methods  Thirty patients with American Society of Anesthesiologists (ASA) physical status Ⅰ-Ⅱ, scheduled for elective intracranial mass lesion surgery under general anesthesia were randomly allocated equally to Shikani optical stylet group (group S) Macintosh laryngoscope group (group M), and GlideScope® videolaryngoscope group (group G). After the patients became unconscious by TCI induction of propofpol and remifentanil, the endotracheal intubation were carried out through above three laryngoscope. The heart rate (HR), blood pressure and rate pressure product (RPP) were recorded. Results  The differences of intubation time, HR, blood pressure and RPP in three groups were not statistically significant (P gt;0.05). After intubation, the HR, blood pressure and RPP of group S and M were obviously higher than those before intubation (P lt;0.05); while there was no obvious change on the HR, systolic pressure at 60-300 s, mean arterial pressure and RPP of group G compared before intubation (P gt;0.05). Conclusions  There are similar hemodynamic responses in the three laryngoscope. GlideScope® is more advantageous to cycle stability.

Citation： LUuml,Peilin,LIU Bin. Hemodynamic Comparison of Different Laryngoscope Tracheal Intubation. West China Medical Journal, 2010, 25(8): 1505-1508. doi: Copy