健忘镇痛慢诱导联合HC可视喉镜在支撑喉镜短小手术中的应用

发布时间：2018-04-16 11:38

本文选题：健忘镇痛慢诱导 + HC可视喉镜　；参考：《临床麻醉学杂志》2015年04期

【摘要】：目的探讨健忘镇痛慢诱导联合HC可视喉镜在支撑喉镜短小手术中的临床应用。方法择期行支撑喉镜下短小手术的患者60例,年龄20~65岁,体重42~85kg,随机分为慢诱导组和对照组,每组30例。慢诱导组为健忘镇痛慢诱导后应用HC可视喉镜行经鼻气管插管,对照组为常规静脉快速诱导后应用Macintosh普通喉镜行经鼻气管插管。记录麻醉诱导前(T0)、插管前(T1)、插管即刻(T2)、插管后3 min(T3)以及支撑喉镜置入前(T4)、置入即刻(T5)、置入后3 min(T6)的MAP和HR。同时记录声门暴露分级(Cormark-Lehane分级)、喉外部压迫操作、Magil插管钳辅助、喉镜上沾血以及麻醉苏醒情况和不良反应。结果与T0时比较,T1时对照组MAP明显降低,HR明显减慢(P0.05),T2、T3、T5、T6时,对照组MAP明显升高,HR明显增快(P0.05)。与对照组比较,慢诱导组声门暴露Ⅰ级例数明显增多,插管时间更短,首次插管成功率明显增高,喉外部压迫操作、Magil插管钳辅助的发生率较少,且应用瑞芬太尼的总剂量明显减少(P0.05)。对照组术毕麻醉恢复时间、拔管时间较慢诱导组明显延长,而慢诱导组的躁动评分、术后3hVAS评分及不良反应明显低于对照组(P0.05)。结论健忘镇痛慢诱导联合HC可视喉镜用于支撑喉镜手术插管方法简单迅速,麻醉诱导期和术中血流动力学平稳,术后苏醒迅速完全,镇痛满意,减少了术后躁动。
[Abstract]:Objective to investigate the clinical application of amnesia and slow induction combined with HC visual laryngoscope in the short operation of supporting laryngoscope.Methods Sixty patients, aged 20 to 65 years old and weighing 42 ~ 85 kg, were randomly divided into slow induction group and control group with 30 cases in each group.The slow induction group was treated with HC visual laryngoscope after slow induction of amnesia, while the control group was treated with Macintosh general laryngoscope after routine intravenous rapid induction.MAP and HRR were recorded before anesthesia induction, before intubation, before intubation, immediately after intubation, 3 min after intubation, 3 min after intubation, 3 min after intubation, 3 min after intubation, 3 min after intubation, 3 min after intubation, 3 min after intubation, 3 min after intubation, and 3 min after intubation.At the same time, Cormark-Lehane classification of glottic exposure was recorded, external laryngeal compression was assisted by Magil cannula forceps, blood on laryngoscope, anaesthesia recovery and adverse reactions were recorded.Results compared with T0, the MAP of the control group was significantly lower than that of the control group. The HR of the control group was significantly lower than that of the control group (P 0.05). The MAP of the control group was significantly higher than that of the control group (P 0.05), and that of the control group was significantly higher than that of the control group (P 0.05).Compared with the control group, the number of glottic exposure grade I in the slow induction group was significantly increased, the intubation time was shorter, the success rate of the first intubation was significantly increased, and the incidence of external laryngeal compression operation was less than that of the external laryngeal compression operation.The total dose of remifentanil was decreased significantly.The anesthesia recovery time and extubation time in the control group were significantly longer than those in the slow induction group, while the restlessness score, postoperative 3hVAS score and adverse reactions in the slow induction group were significantly lower than those in the control group (P 0.05).Conclusion slow induction of amnesia combined with HC visual laryngoscope is a simple and rapid method for intubation of propped laryngoscope. The anesthesia induction period and intraoperative hemodynamics are stable, postoperative recovery is rapid and complete, analgesia is satisfactory, and postoperative restlessness is reduced.
【作者单位】：大连市友谊医院麻醉科;
【分类号】：R614

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