目的:观察光棒引导气管插管对老年全麻患者血流动力学及Narcotrend指数(NI)的影响。方法:选择行气管插管全身麻醉老年患者60例,随机分成2组,A组在光棒引导下完成气管插管,B组使用Macintosh喉镜完成气管插管,记录2组患者诱导前(T0)、插管前(T1)、插管即刻(T2)、插管后1 min(T3)、插管后3 min(T4)的心率(HR)、平均动脉压(MAP)、血氧饱和度及NI,记录插管时间、插管引起牙齿脱落情况、术后随访咽痛情况及是否出现术中知晓。结果:A组患者仅T2的HR和MAP较T1升高(P<0.05),B组患者T2~T4的HR和MAP较T1升高,且较A组升高,差异有统计学意义(P<0.05);A组患者NI平稳,诱导后各时间点差异无统计学意义(P>0.05),B组患者NI在T2、T3较T1升高,且较A组升高,差异有统计学意义(P<0.05)。A组患者气管插管时间较B组缩短(P<0.05),术后随访发现A组咽痛较B组明显减少(P<0.05),牙齿脱落情况及术中知晓情况两组无差异(P>0.05)。结论:光棒引导气管插管对老年全麻患者血流动力学以及NI的影响较使用喉镜小,熟练地使用该插管技术能更好地保证老年全麻患者围术期安全。 |
Objective:To observe the effect of tracheal intubation guided with light wand on hemodynamics and Narcotrend index(NI) in the elderly for general anesthesia. Methods:A total of 60 elderly patients who would undergo general anesthesia were randomly divided into 2 groups. In group A,the tracheal intubation were guided with light wand and in group B were used the Macintosh laryngoscope. The heart rate(HR),mean arterial pressure(MAP),the oxygen saturation of blood, NI at specific time, before induction(T0), before intubation(T1), intubation(T2), 1 min after intubation(T3), 3 min after intubation(T4), the tracheal intubation time, the condition of loss of teeth by tracheal intubation, pharyngalgia after operation and intraoperative awareness were recorded. Results:The HR and MAP were significant higher just at T2 than T1 in group A(P<0.05). In group B, the HR and MAP were significant higher at T2-T4 than T1 and the same time in group A(P<0.05). The NI in group A was steady and different times after induce were not differed significantly(P>0.05). In group B, the NI was significant higher at T2, T3 than T1 and the same time in group A(P<0.05).The tracheal intubation time in group A was significantly shorter than group B(P<0.05), and pharyngalgia after operation was found less than group B(P<0.05). The condition of loss of teeth by tracheal intubation and intraoperative awareness were not differed significantly(P>0.05). Conclusion:The effect of tracheal intubation guided with light wand on hemodynamics and NI in the elderly for general anesthesia was smaller than using laryngoscope. Using this intubation technique skillfully could guarantee the safety of the elderly with general anesthesia during perioperative period. |
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