Department of Anesthesiology and Pain Medicine, School of Medicine, Keimyung University, Daegu, Korea.
Korean J Anesthesiol. 2010 Aug;59(2):116-8. doi: 10.4097/kjae.2010.59.2.116. Epub 2010 Aug 20.
There are a few reports about bradycardia or asystole caused by direct laryngoscopy. However, we encountered severe bradycardia in response to suspension laryngoscopy for laryngeal polypectomy after safely completing tracheal intubation using a direct laryngoscope with a curved blade. The tip of the curved blade of the direct laryngoscope is positioned at the vallecula (between the base of the tongue and the pharyngeal surface of the epiglottis) during tracheal intubation, while the blade tip of the suspension laryngoscope lifts the laryngeal surface of the epiglottis or supraglottic area during surgery. Therefore, suspension laryngoscopy can be said more vagotonic than curved-blade direct laryngoscopy. Because of the possibility of bradycardia induced by suspension laryngoscopy, clinicians must be careful about severe bradycardia even after safely completing intubation using direct laryngoscopy.
有一些关于直接喉镜检查引起心动过缓和心搏停止的报告。然而，我们在使用弯型刀片的直接喉镜成功完成气管插管后，为进行喉息肉切除术而改用悬镜式喉镜时，遇到了严重的心动过缓。在进行气管插管时，直接喉镜的弯型刀片尖端位于会厌谷（舌根部和会厌咽面之间），而悬镜式喉镜的刀片尖端在手术中提起会厌或声门上区域。因此，悬镜式喉镜可以说比弯型刀片直接喉镜更具迷走神经兴奋作用。由于悬镜式喉镜可能引起心动过缓，因此即使在使用直接喉镜安全完成插管后，临床医生也必须注意严重的心动过缓。
