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[使用麦金托什喉镜和麦考伊喉镜插管时的血流动力学反应]

[Hemodynamic response to intubation with Macintosh and McCoy blades].

作者信息

Román J, Beltrán de Heredia B, García-Velasco P, Parramón F, García R, Vilaplana J, Villalonga A

机构信息

Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital de Girona Doctor Josep Trueta.

出版信息

Rev Esp Anestesiol Reanim. 1996 May;43(5):177-9.

PMID:8753922
Abstract

INTRODUCTION

The McCoy laryngoscope incorporates a modification of the Macintosh blade designed to facilitate laryngoscopy and difficult intubation. One end is articulated to allow better viewing of the larynx. Use of this blade reduces pressure placed on tissues in the supraglottic area during laryngoscopy.

OBJECTIVE

We designed this study to compare the hemodynamic repercussions of laryngoscopy and tracheal intubation (LTI) performed with either a Macintosh or the McCoy blade.

PATIENTS AND METHOD

Sixty ASA I-II patients scheduled for elective surgery requiring LTI were randomly assigned to 2 groups of 30 patients each. In both groups anesthetic induction was achieved with 0.04 mg.kg-1 midazolam, 0.002 mg.kg-1 fentanyl, 2 mg.kg-1 propofol and 0.1 mg.kg-1 vecuronium. In group 1 LTI laryngoscopy and intubation were performed using the Macintosh size 3 blade and in group 2 the McCoy size 3 blade was used. Systolic and diastolic arterial pressures and heart rate were recorded in each patient before anesthetic induction (baseline), 1 minute after induction and 5 minutes after start of LTI.

RESULTS

We found no significant differences between the 2 groups at any of the recording times.

CONCLUSION

The data obtained do not allow us to assert that there is any difference in hemodynamic response to LTI associated to type of blade used.

摘要

引言

麦考伊喉镜对麦金托什叶片进行了改良,旨在便于喉镜检查和困难插管。其一端有关节连接,以便更好地观察喉部。使用这种叶片可减少喉镜检查期间声门上区域组织所受的压力。

目的

我们设计本研究以比较使用麦金托什叶片或麦考伊叶片进行喉镜检查和气管插管(LTI)时的血流动力学影响。

患者与方法

60例计划接受需要LTI的择期手术的美国麻醉医师协会(ASA)I-II级患者被随机分为两组,每组30例。两组均用0.04mg/kg咪达唑仑、0.002mg/kg芬太尼、2mg/kg丙泊酚和0.1mg/kg维库溴铵进行麻醉诱导。第1组使用3号麦金托什叶片进行LTI喉镜检查和插管,第2组使用3号麦考伊叶片。在麻醉诱导前(基线)、诱导后1分钟和LTI开始后5分钟记录每位患者的收缩压、舒张压和心率。

结果

我们发现在任何记录时间两组之间均无显著差异。

结论

所获得的数据无法让我们断言与所用叶片类型相关的LTI血流动力学反应存在任何差异。

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