气道黏膜序贯式表面麻醉的清醒气管插管效果  

Outcomes of conscious endotracheal intubation with sequential airway surface anesthesia

作　　者：方明[1] 李荣[1] 张中军[1] 项舒玮[1] 吕国忠[2] 

机构地区：[1]无锡市第三人民医院麻醉科,214041 [2]无锡市第三人民医院烧伤整形科,214041

出　　处：《江苏医药》2010年第23期2753-2754,共2页Jiangsu Medical Journal

摘　　要：目的比较不同模式气道黏膜麻醉的清醒气管插管效果。方法面颈部瘢痕挛缩患者75例分为4组。A组咽部1%丁卡因喷雾3次;B组加用环甲膜穿刺注射2%利多卡因2 ml;C组2%利多卡因胶浆10 ml含漱后,用2%利多卡因0.1 ml/kg经氧气雾化吸入5 min;D组含漱后,将可塑型麻醉喷雾器经口腔深入咽喉接近声门处,嘱患者做深度吸气时分次喷雾1%利多卡因0.1 ml/kg。记录插管条件及患者反应。结果 C、D组提供的插管条件明显优于A、B组(P<0.05)。与A、B组比较,C、D组患者术中与术后舒适度优于A、B组(P<0.05)。C、D组插管过程中的心率(HR)和平均动脉压(MAP)较为平稳(P<0.05)。结论 口咽喉序贯式表面麻醉效果完善,显著提高清醒气管插管的成功率和舒适度。Objective To compare the outcomes of conscious endotracheal intubation with different techniques of airway surface anesthesia.Methods A total of 75 cases with difficult airway was intubated under surface anesthesia with 1% tetracaine spraying（group A）,additional 2% lidocaine 2 ml topical anesthesia via thyrocricocentesis（group B）,10 ml gargled with 2% lidocaine oral mucilage and nebulization with 1% lidocaine 0.1 ml/kg（group C） or oral mucilage plus 1% lidocaine 0.1 ml/kg spraying（group D）.Intubation condition and response of patients to intubation were recorded.ResultsIntubation condition and comfotability of patients were much better in groups of C and D than those in groups of A and B（P0.05）.Conclusion Conscious endotracheal intubation with sequential surface anesthesia technique may provide better intubation condition and less adverse response in patients with difficult airway.

关 键 词：表面麻醉 困难气道 清醒气管插管 

分 类 号：R614[医药卫生—麻醉学]