经鼻腔置气管导管至咽喉对困难气管插管非需肌松手术麻醉的探讨  

A Study of Naso-tracheal Intubation without Neuromuscular Relaxant to the Patient with Difficult Intubation

作　　者：张汉生[1] 刘平 姚尚龙[1] 

机构地区：[1]同济医科大学附属协和医院麻醉学教研室,武汉430022

出　　处：《同济医科大学学报》2000年第6期542-544,共3页Acta Universitatis Medicinae Tongji

摘　　要：观察气管插管困难而非需肌松手术麻醉者以探讨采用经鼻腔置气管导管至咽喉对困难气管插管非需肌松手术麻醉方法的可行性。１６例颈部疤痕、下颌关节病及面部疤痕 ＡＳＡⅠ～Ⅱ级的患者，在氯胺酮为基础麻醉后３ｍｉｎ经鼻腔置入咽喉导管。麻醉中保留患者自主呼吸。吸入氟烷、氧、笑气维持麻醉。于基础麻醉后１、２、３、４、５ｍｉｎ和１０ｍｉｎ测量患者的ＳＰ、ＤＰ和 ＨＲ。麻醉后１５、３０ｍｉｎ和６０ ｍｉｎ测定患者ＶＴ、ＰａＯ２和 ＰａＣＯ２。结果表明：置管后ＳＰ、ＤＰ和ＨＲ轻微增加，ＰａＯ２明显上升，ＰａＣＯ２轻度增加，ＶＴ下降．结果提示：经鼻腔置气管导管至咽喉对气管插管非需肌松手术麻醉咽喉的方法效果满意，氧合好，对心血管系统影响轻微。The feasibility of naso-tracheal intubation without neuromuscular relaxant to the patient with difficult intubation was investigated. Sixteen patients with neck scar, mandibular joint diseases or face scar (ASAⅠ-Ⅱ) were administered ketamine to gain basal anesthesia followed by tracheal intubation via nose 3 min later. Spontaneous breath was maintained during anesthesia. Anesthesia was maintained with halothane-nitrous oxide-oxygen. SP, DP and HR were measured at 1, 2. 3. 4, 5 and 10 min after basal anesthesia. VT, PaO2 and PaCO2 were determined at 15, 30 and 60 min of anesthesia. Results showed that SP, DP and HR were in- creased slightly, PaO2 increased significantly and PaCO2 decreased slightly and VT decreased. It was concluded that tracheal intubation via nose could achieve perfect effect, good oxygenation and had slight disturbance on cardiovascular system.

关 键 词：鼻腔气管插管 麻醉 气管插管 非需肌松手术麻醉 

分 类 号：R614.1[医药卫生—麻醉学]