可视光棒与直接喉镜在牙齿松动患者全身麻醉气管插管中的应用比较  

Comparison of application of visible light rod and direct laryngoscope in endotracheal intubation under general anesthesia in patients with loose teeth

作　　者：程好 施灵丹 刘晓庆 CHENG Hao;SHI Lingdan;LIU Xiaoqing(Department of Anesthesiology,Yongkang Hospital of Traditional Chinese Medicine,Yongkang 321300,Zhejiang,China)

机构地区：[1]永康市中医院麻醉科,浙江永康321300

出　　处：《中国现代医生》2023年第12期29-32,73,共5页China Modern Doctor

基　　金：永康市科技计划项目(202051)。

摘　　要：目的比较可视光棒与直接喉镜在牙齿松动患者全身麻醉气管插管中的应用价值。方法将2020年1月至2021年1月永康市中医院120例牙齿松动患者,采用随机数字表法分为对照组和研究组,每组各60例。患者入室后使用地塞米松5mg、咪唑安定0.03mg/kg、丙泊酚2~3mg/kg、舒芬太尼0.4μg/kg、瑞芬太尼效应室靶控浓度2~4ng/ml、顺式阿曲库铵0.2mg/kg麻醉诱导,待肌肉松驰满意后气管插管。对照组采用直接喉镜进行气管插管,研究组采用可视光棒辅助全身麻醉气管插管,比较两组患者牙齿和口腔黏膜损伤发生率、插管时间、插管成功率、插管前后生命体征变化、术后咽痛和声音嘶哑并发症发生率。结果研究组牙齿损伤总发生率及口咽黏膜出血低于对照组(P<0.05);观察组气管插管时间、单次插管成功率及插管成功率研究组高于对照组(P<0.05);麻醉诱导前、喉镜或光棒插入即刻,两组患者的心率及血压比较,差异无统计学意义(P>0.05);插管后即刻、插管后1min和3min的心率及平均动脉压研究组均低于对照组(P<0.05);研究组患者的心动过速、术后1d声音嘶哑、咽喉痛发生低于对照组(P<0.05)。结论可视光棒辅助全身麻醉气管插管可有效提高插管成功率,降低牙齿和口腔黏膜损伤,有利于维持心率、血压稳定,降低术后咽痛和声音嘶哑并发症发生率。Objective To compare the application value of visible light rod and direct laryngoscope in endotracheal intubation under general anesthesia in patients with loose teeth.Methods A total of 120 patients with loose teeth in Yongkang Hospital of Traditional Chinese Medicine from January 2020 to January 2021 were included and divided into control group and study group according to the random number table method,with 60 cases in each group.Patients were anesthetized with dexamethasone 5mg,midazolam 0.03mg/kg,propofol 2-3mg/kg,sufentanil 0.4μg/kg,target-controlled concentration of remifentanil effect chamber 2-4ng/ml and cis-atracurium 0.2mg/kg,and intubated after muscle relaxation was satisfied.The control group was given direct laryngoscope for general anesthesia tracheal intubation,while the study group was given visual light rod-assisted general anesthesia tracheal intubation.The incidence of dental and oral mucosal injury,intubation time,intubation success rate,changes in vital signs before and after intubation,postoperative sore throat and hoarseness complications were compared.Results The total incidence of tooth damage and oropharyngeal mucosal bleeding in the study group were lower than those in the control group(P<0.05).The time of tracheal intubation,the success rate of single intubation and the success rate of intubation in the study group were higher than those in the control group(P<0.05).There was no significant difference in heart rate and blood pressure between the two groups before anesthesia induction and immediately after laryngoscope or light rod insertion(P>0.05).Heart rate and mean arterial pressure immediately after intubation,1min and 3min after intubation in the research group was lower than the control group(P<0.05).The incidence of tachycardia,hoarseness and sore throat on the 1st postoperative day in the study group was lower than that in the control group(P<0.05).Conclusion Visual light rod-assisted tracheal intubation under general anesthesia can effectively improve the success rate of in

关 键 词：全身麻醉气管插管 牙齿松动 可视光棒 直接喉镜 

分 类 号：R614[医药卫生—麻醉学]