Noguchi Takashi, Koga Kazunori, Shiga Yousuke, Shigematsu Akio
Department of Anesthesia, Chikuho Rosai Hospital, Kaho-gun, Japan.
Can J Anaesth. 2003 Aug-Sep;50(7):712-7. doi: 10.1007/BF03018715.
To compare the ease of tracheal intubation facilitated by the gum elastic bougie or the malleable stylet while applying cricoid pressure.
Sixty American Society of Anesthesiologists I-III adult patients undergoing elective surgeries participated in this study. After induction of anesthesia with 2.5 mg x kg(-1) propofol and vecuronium 0.1 mg x kg(-1), the laryngeal view was assessed without and with cricoid pressure. Patients were allocated randomly into two groups: a gum elastic bougie or stylet group. One of the two devices was used for tracheal intubation while applying cricoid pressure. The duration and ease of tracheal intubation was recorded.
In 58 patients, the trachea was intubated at the first attempt. In the stylet group, tracheal intubation was difficult and needed more time, especially when the glottic opening was not visible. In the bougie group, the duration and ease of intubation was not influenced by laryngeal view. In the remaining two patients with Cook's modified 3b laryngeal view, it was impossible to intubate the trachea with these devices.
Applying cricoid pressure worsened laryngeal view. The use of a gum elastic bougie was more effective than the use of a stylet to facilitate intubation.
比较在施加环状软骨压迫时,弹性橡胶探条或可塑型管芯辅助气管插管的难易程度。
60例接受择期手术的美国麻醉医师协会I-III级成年患者参与本研究。在使用2.5mg/kg丙泊酚和0.1mg/kg维库溴铵诱导麻醉后,评估有无环状软骨压迫时的喉镜视野。患者被随机分为两组:弹性橡胶探条组或管芯组。在施加环状软骨压迫的同时,使用两种器械之一进行气管插管。记录气管插管的持续时间和难易程度。
58例患者首次尝试即成功气管插管。在管芯组,气管插管困难且需要更多时间,尤其是在声门开口不可见时。在探条组,插管的持续时间和难易程度不受喉镜视野的影响。在其余两名具有库克改良3b级喉镜视野的患者中,使用这些器械无法进行气管插管。
施加环状软骨压迫会使喉镜视野变差。使用弹性橡胶探条比使用管芯辅助插管更有效。