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[Airtraq可视喉镜与麦金托什喉镜对非眼科手术眼压影响的随机对照研究]

[A randomised comparative study of the effect of Airtraq optical laryngoscope vs. Macintosh laryngoscope on intraocular pressure in non-ophthalmic surgery].

作者信息

Das Bikramjit, Samal Rajiv Kumar, Ghosh Arup, Kundu Ratul

机构信息

Departamento de Anestesiologia, Hospital da Faculdade de Medicina e Escola de Medicina Tropical Governamental, Uttarakhand, Índia.

Departamento de Anestesiologia, Instituto de Ensino Médico de Pós-Graduação e Pesquisa, Bengala Ocidental, Índia.

出版信息

Rev Bras Anestesiol. 2016 Jan-Feb;66(1):19-23. doi: 10.1016/j.bjan.2014.07.005. Epub 2015 Apr 18.

Abstract

BACKGROUND

We compared intraocular pressure changes following laryngoscopy and intubation with conventional Macintosh blade and Airtraq optical laryngoscope.

METHODS

Ninety adult patients were randomly assigned to study group or control group. Study group (n=45) - Airtraq laryngoscope was used for laryngoscopy. Control group (n=45) - conventional Macintosh laryngoscope was used for laryngoscopy. Preoperative baseline intraocular pressure was measured with Schiotz tonometer. Laryngoscopy was done as per group protocol. Intraocular pressure and haemodynamic parameters were recorded just before insertion of the device and subsequently three times at an interval of one minute after insertion of the device.

RESULTS

Patient characteristics, baseline haemodynamic parameters and baseline intraocular pressure were comparable in the two groups. Following insertion of the endotracheal tube with Macintosh laryngoscope, there was statistically significant rise in heart rate and intraocular pressure compared to Airtraq group. There was no significant change in MAP. Eight patients in Macintosh group had tongue-lip-dental trauma during intubation, while only 2 patients received upper airway trauma in Airtraq group.

CONCLUSION

We conclude that Airtraq laryngoscope in comparison to Macintosh laryngoscope results in significantly fewer rises in intraocular pressure and clinically less marked increase in haemodynamic response to laryngoscopy and intubation.

摘要

背景

我们比较了使用传统麦金托什喉镜和Airtraq光学喉镜进行喉镜检查和插管后的眼压变化。

方法

90例成年患者被随机分为研究组或对照组。研究组(n = 45)——使用Airtraq喉镜进行喉镜检查。对照组(n = 45)——使用传统麦金托什喉镜进行喉镜检查。术前使用施氏眼压计测量基线眼压。按照分组方案进行喉镜检查。在插入器械前以及插入器械后每隔1分钟记录3次眼压和血流动力学参数。

结果

两组患者的特征、基线血流动力学参数和基线眼压具有可比性。与Airtraq组相比,使用麦金托什喉镜插入气管导管后,心率和眼压有统计学意义的升高。平均动脉压无显著变化。麦金托什组有8例患者在插管期间出现舌唇牙损伤,而Airtraq组只有2例患者出现上呼吸道损伤。

结论

我们得出结论,与麦金托什喉镜相比,Airtraq喉镜导致眼压升高明显较少,并且对喉镜检查和插管的血流动力学反应在临床上增加不明显。

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