Casati A, Aldegheri G, Fanelli G, Gioia L, Colnaghi E, Magistris L, Torri G
Department of Anesthesiology, University of Milan, Italy.
J Clin Anesth. 1999 May;11(3):216-9. doi: 10.1016/s0952-8180(99)00029-x.
To evaluate the changes in hemodynamic variables and intraocular pressure (IOP) after tracheal intubation using either lightwand or direct-vision laryngoscopy techniques.
Prospective, randomized study.
Inpatient anesthesia at a University Anesthesia Department.
50 normotensive, ASA physical status I and II patients, without ocular or cardiovascular diseases, and with a Mallampati score no greater than 2.
After intravenous (i.v.) midazolam premedication (0.05 mg.kg-1), general anesthesia was induced with fentanyl (1 microgram.g-1) and thiopental sodium (5 mg.g-1) followed by vecuronium bromide (0.1 mg.g-1), then patients were randomly allocated to receive either the lightwand (Trachlight, n = 25) or direct-vision laryngoscopy (Laryngoscopy, n = 25) intubating techniques. General anesthesia was maintained with 1% isoflurane and 60% nitrous oxide in oxygen mixture for 5 minutes.
Baseline hemodynamic variables were recorded 10 minutes after i.v. premedication, and then every minute after tracheal intubation. Intraocular pressure measurements were performed by means of a computerized indentation tonometer after general anesthesia induction and then 1 and 5 minutes after tracheal intubation. In both groups, mean arterial blood pressure and heart rate increased from baseline, without differences between the two groups. One minute after intubation, IOP increased in both groups: the mean percentage increase was 32% in the Laryngoscopy group and 16% in the Trachlight group. However, this difference was not statistically significant. Five minutes after intubation, IOP decreased to baseline values in both groups.
We conclude that in healthy patients without ocular disease, using a lightwand intubating technique does not reduce the hemodynamic responses and increase in IOP associated with tracheal intubation as compared with conventional direct-vision laryngoscopy.
评估使用光棒或直接喉镜技术进行气管插管后血流动力学变量和眼压（IOP）的变化。
前瞻性随机研究。
大学麻醉科的住院麻醉。
50例血压正常、ASA身体状况为I级和II级、无眼部或心血管疾病且Mallampati评分不大于2的患者。
静脉注射咪达唑仑进行术前用药（0.05mg/kg）后，用芬太尼（1μg/kg）和硫喷妥钠（5mg/kg）诱导全身麻醉，随后给予维库溴铵（0.1mg/kg），然后将患者随机分配接受光棒（Trachlight，n = 25）或直接喉镜（喉镜检查，n = 25）插管技术。用1%异氟醚和60%氧化亚氮与氧气的混合气体维持全身麻醉5分钟。
静脉注射术前用药10分钟后记录基线血流动力学变量，气管插管后每分钟记录一次。全身麻醉诱导后以及气管插管后1分钟和5分钟，使用计算机压陷眼压计进行眼压测量。两组患者的平均动脉血压和心率均较基线升高，两组间无差异。插管后1分钟，两组眼压均升高：喉镜检查组平均升高百分比为32%，光棒组为16%。然而，这种差异无统计学意义。插管后5分钟，两组眼压均降至基线值。
我们得出结论，在无眼部疾病的健康患者中，与传统直接喉镜检查相比，使用光棒插管技术不会降低与气管插管相关的血流动力学反应和眼压升高。
