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在全身麻醉下比较气管插管时血流动力学反应和口咽并发症:评估常规喉镜、视频喉镜和硬性喉镜。

Comparative Analysis of Hemodynamic Responses and Oropharyngeal Complications in Tracheal Intubation: Evaluating Conventional, Video, and Rigid Video Laryngoscopes Under General Anesthesia.

机构信息

Department of Surgery and Anesthesia, Third Affiliated Hospital of Sun Yat-sen University Yuedong Hospital, Meizhou, Guangdong, China.

出版信息

Med Sci Monit. 2024 Sep 5;30:e944916. doi: 10.12659/MSM.944916.

Abstract

BACKGROUND This study aimed to compare the hemodynamic changes and the occurrence of oropharyngeal complications among patients undergoing tracheal intubation with an ordinary laryngoscope, video laryngoscope, and rigid video laryngoscope under general anesthesia. MATERIAL AND METHODS Patients undergoing elective tracheal intubation under general anesthesia were prospectively enrolled as study subjects. Hemodynamic indicators such as diastolic blood pressure (DBP), systolic blood pressure (SBP), mean arterial pressure (MAP), and heart rate (HR), as well as the incidences of oropharyngeal complications, including dental injury, oral mucosal injury, hoarseness, sore throat, and dysphagia, were observed in the patients of 3 groups (group A: ordinary laryngoscope, group B: video laryngoscope, group C: rigid video laryngoscope). Observations were made after anesthesia induction (T₀), immediately after tracheal intubation (T₁), and at 5 min after intubation (T₂). RESULTS The HR at T1 in group A was significantly higher than in groups B and C (P<0.05). However, the difference in the number of tracheal intubations was statistically significant among the 3 groups (P<0.05); group C exhibited the highest first-time success rate of tracheal intubation (95%), whereas group A had the highest failure rate (5%). Significant differences were also noted in the incidences of oral mucosal injury and sore throat among the groups (P<0.05), with the highest incidence in group A and the lowest in group C. CONCLUSIONS Compared with the ordinary laryngoscope, tracheal intubation using a video or rigid video laryngoscope results in milder hemodynamic impacts and fewer intubation-related complications. The rigid video laryngoscope may be safer and more effective.

摘要

背景

本研究旨在比较普通喉镜、视频喉镜和硬性视频喉镜在全身麻醉下气管插管时的血流动力学变化和口咽并发症的发生情况。

材料和方法

前瞻性纳入全身麻醉下择期行气管插管的患者作为研究对象。观察 3 组患者(A 组:普通喉镜、B 组:视频喉镜、C 组:硬性视频喉镜)的血流动力学指标(舒张压、收缩压、平均动脉压和心率)以及口咽并发症(包括牙齿损伤、口腔黏膜损伤、声音嘶哑、咽痛和吞咽困难)的发生率。观察指标包括麻醉诱导后(T₀)、气管插管即刻(T₁)和插管后 5 分钟(T₂)。

结果

A 组患者 T₁时的心率明显高于 B 组和 C 组(P<0.05)。但是,3 组患者的气管插管次数差异有统计学意义(P<0.05);C 组的首次气管插管成功率最高(95%),A 组的失败率最高(5%)。各组间口腔黏膜损伤和咽痛的发生率也存在显著差异(P<0.05),A 组发生率最高,C 组发生率最低。

结论

与普通喉镜相比,使用视频喉镜或硬性视频喉镜进行气管插管可减轻血流动力学波动,减少与插管相关的并发症。硬性视频喉镜可能更安全、更有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7060/11385090/2cb77abac1aa/medscimonit-30-e944916-g001.jpg

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