超声引导环甲膜穿刺气道表麻对经鼻气管插管反应的影响

魏辉明; 王玲玲; 邱昌明; 李文锋; 麻伟青

超声引导环甲膜穿刺气道表麻对经鼻气管插管反应的影响

成都军区昆明总医院麻醉科

基金项目:

基金：成都军区“十二五”医学科研基金资助项目 (B14013);

计量
- 文章访问数: 2162
- HTML全文浏览量: 756
- PDF下载量: 66
- 被引次数: 0
出版历程
- 收稿日期: 2017-05-22

Effect of Ultrasound-guided Cricothyroid Membrane Puncture Airway Surface Anesthesia on Nasotracheal Intubation Response

Funds:

基金：成都军区“十二五”医学科研基金资助项目 (B14013);

摘要

摘要: 目的探讨超声引导环甲膜穿刺气道表面麻醉对经鼻气管插管反应的影响.方法择期行咽喉部手术患者60例, 随机分为超声组和盲探组 (n=30) .超声组在超声引导下环甲膜穿刺后注射2%利多卡因2 mL;盲探组以传统触诊法定位后穿刺注药.记录镇静时 (T0) 、穿刺注药后时 (T1) 、插管即刻 (T2) 、插管后2 min时 (T3) 、插管后5 min时 (T4) 的HR、MAP和心率收缩压乘积 (RPP) ;记录注药时呛咳评分、术后咽痛等并发症率.结果与基础值比较, T1时2组MAP、HR和RPP升高 (P<0.05) ;与盲探组比较, 超声组各时点差异无统计学意义 (P>0.05) .与盲探组比较, 超声组穿刺时呛咳程度较轻、术后咽痛发生率降低 (P<0.05) .结论超声引导环甲膜穿刺气道表麻对经鼻气管插管引起的插管反应与传统盲探法相似, 但相关并发症发生率较低.
- 超声引导 /
- 环甲膜穿刺 /
- 表面麻醉 /
- 经鼻气管插管
Abstract: Objective To invastigate effect of ultrasound-guided cricothyroid membrane puncture airway surface anesthesia on nasotracheal intubation response.Methods Sixty patients undergoing elective pharyngeal throat surgery were randomly divided into ultrasound group and blind group (n=30) .Ultrasound group patients were given 2% lidocaine 2 m L by ultrasound-guided undergoing cricothyroid membrane puncture, while blind group patients were treated by traditional palpation method.HR, MAP and heart rate systolic pressure product (RPP) were recorded at sedative (T0) , after administrating (T1) , intubation immediately (T2) , 2 minutes after intubation (T3) , 5 minutes after intubation (T4) .Cough score and incidence of postoperative sore throat were recorded.Results HR, MAP and RPP of the two groups had no significant differences in the same time points (P>0.05) .Compared with the blind group, the degree of cough and incidence of postoperative sore throat were lighter in the ultrasound group (P<0.05) .Conclusion The effect of ultrasound-guided cricothyroid membrane puncture surface anesthesia on nasotracheal intubation response is similar to that of traditional palpation method, but the incidence of related complications is lower.
- Ultrasound-guided /
- Cricothyroid membrane puncture /
- Surface anesthesia /
- Nasotracheal intubation

HTML全文

参考文献(15)

[1]李荣, 张中军, 毛洪雅, 等.罗哌卡因与利多卡因气道表面麻醉对气管插管及拔管反应影响的比较[J].临床麻醉学杂志, 2016, 32 (5) :504-505.[1]李荣, 张中军, 毛洪雅, 等.罗哌卡因与利多卡因气道表面麻醉对气管插管及拔管反应影响的比较[J].临床麻醉学杂志, 2016, 32 (5) :504-505.
[2]	[2]GALGON R E, SCHROEDER K M.Accuracy of surface landmark identification for cannula cricothyroidotomy[J].Anaesthesia, 2011, 66 (7) :621-622.[2]GALGON R E, SCHROEDER K M.Accuracy of surface landmark identification for cannula cricothyroidotomy[J].Anaesthesia, 2011, 66 (7) :621-622.
[3]	[3]JI M, TAO J, CHENG M, et al.Endotracheal administration of sufentanil and tetracaine during awake fiberoptic intubation[J].Am J Ther, 2016, 23 (1) :e92-97.[3]JI M, TAO J, CHENG M, et al.Endotracheal administration of sufentanil and tetracaine during awake fiberoptic intubation[J].Am J Ther, 2016, 23 (1) :e92-97.
[4]杨云丽, 麻伟青, 张承华, 等.高龄髂关节置换术后谵妄患者S-100β蛋白和NSE浓度的变化及临床意义[J].昆明医科大学学报, 2014, 35 (4) :61-64.[4]杨云丽, 麻伟青, 张承华, 等.高龄髂关节置换术后谵妄患者S-100β蛋白和NSE浓度的变化及临床意义[J].昆明医科大学学报, 2014, 35 (4) :61-64.
[5]	[5]KRAUSE M, KHATIBI B, SZTAIN, et al.Ultrasound-guided airway blocks using a curvilinear probe[J].J Clin Anesth, 2016, 33 (9) :408-412.[5]KRAUSE M, KHATIBI B, SZTAIN, et al.Ultrasound-guided airway blocks using a curvilinear probe[J].J Clin Anesth, 2016, 33 (9) :408-412.
[6]	[6]DEVELI S, YALCIN B, YAZAR F.Topographical anatomy of cricothyroid membrane and its relation with invasive airway access[J].Clin Anat, 2016, 29 (7) :949-954.[6]DEVELI S, YALCIN B, YAZAR F.Topographical anatomy of cricothyroid membrane and its relation with invasive airway access[J].Clin Anat, 2016, 29 (7) :949-954.
[7]	[7]LIU H H, ZHOU T, WEI J Q, et al.Comparison between remifentanil and dexme-detomidine for sedation during modified awake fiberoptic intubation[J].Exp Ther Med, 2015, 9 (4) :1259-1264.[7]LIU H H, ZHOU T, WEI J Q, et al.Comparison between remifentanil and dexme-detomidine for sedation during modified awake fiberoptic intubation[J].Exp Ther Med, 2015, 9 (4) :1259-1264.
[8]王雯, 傅润乔.喉镜和气管插管应激反应的产生和预防[J].临床麻醉学杂志, 2013, 29 (8) :817-819.[8]王雯, 傅润乔.喉镜和气管插管应激反应的产生和预防[J].临床麻醉学杂志, 2013, 29 (8) :817-819.
[9]	[9]GREEN J S, TSUI B C.Use of a nerve stimulator to assist cricothyroid membrane puncture during difficult airway topicalization[J].Can J Anaesth, 2015, 62 (10) :1126-1127.[9]GREEN J S, TSUI B C.Use of a nerve stimulator to assist cricothyroid membrane puncture during difficult airway topicalization[J].Can J Anaesth, 2015, 62 (10) :1126-1127.
[10]	[10]APFELBAUM J L, HAGBERG C A, CAPLAN R A, et al.Practice guidelines for management of the difficult airway:an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway[J].Anesthesiology, 2013, 118 (2) :251-270.[10]APFELBAUM J L, HAGBERG C A, CAPLAN R A, et al.Practice guidelines for management of the difficult airway:an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway[J].Anesthesiology, 2013, 118 (2) :251-270.
[11]	[11]DALESIO N M, KATTAIL D, ISHMAN S L, et al.Ultrasound use in the pediatric airway:the time has come[J].A Case Rep, 2014, 2 (3) :23-26.[11]DALESIO N M, KATTAIL D, ISHMAN S L, et al.Ultrasound use in the pediatric airway:the time has come[J].A Case Rep, 2014, 2 (3) :23-26.
[12]	[12]HU R, LIU J X, JIANG H.Dexmedetomidine versus remifentanil sedation during awake fiberoptic nasotracheal intubation:a double-blinded randomized controlled trial[J].J Anesth, 2013, 27 (2) :211-217.[12]HU R, LIU J X, JIANG H.Dexmedetomidine versus remifentanil sedation during awake fiberoptic nasotracheal intubation:a double-blinded randomized controlled trial[J].J Anesth, 2013, 27 (2) :211-217.
[13]	[13]PRITHISHKUMAR I J, FELICIA C.Histology of the cricothyroid membrane:a clinical perspective[J].Indian J Otolaryngol Head Neck Surg, 2014, 66 (Supp11) :316-319.[13]PRITHISHKUMAR I J, FELICIA C.Histology of the cricothyroid membrane:a clinical perspective[J].Indian J Otolaryngol Head Neck Surg, 2014, 66 (Supp11) :316-319.
[14]	[14]SOLEIMANPOUR H, SHAMS VAHDATI S, MAHMOODPOOR A, et al.Modified cricothyroido-tomy in skill laboratory[J].J Cardiovasc Thorac Res, 2012, 4 (3) :73-76.[14]SOLEIMANPOUR H, SHAMS VAHDATI S, MAHMOODPOOR A, et al.Modified cricothyroido-tomy in skill laboratory[J].J Cardiovasc Thorac Res, 2012, 4 (3) :73-76.
[15]	[15]YILDIZ G, GKSU E, ENFER A, et al.Comparison of ultrasonography and surface landmarks in detecting the localization for cricothyroidotomy[J].Am J Emerg Med, 2016, 34 (2) :254-256.[15]YILDIZ G, GKSU E, ENFER A, et al.Comparison of ultrasonography and surface landmarks in detecting the localization for cricothyroidotomy[J].Am J Emerg Med, 2016, 34 (2) :254-256.

相关文章(20)

[1]	毛健宇, 陈建军, 阎静楠, 王泉, 詹力, 李石乔, 保文莉. 超声引导下肋间神经脉冲射频治疗胸椎高节段带状疱疹后神经痛的临床疗效, 昆明医科大学学报.
[2]	朱丽波, 许艳花, 李金粉, 胡雪, 鲁春燕, 陆昆, 段留艳, 李焕义. 超声引导下经外周置入中心静脉导管在新生儿血管通路穿刺困难中的临床应用, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20230415
[3]	杨云丽, 李娜, 邱昌明, 普俊杰, 聂维, 李治贵. 超声引导下前路腰方肌阻滞对髋关节手术患儿术后镇痛效果, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20230426
[4]	鲁月, 邱昌明, 杨云丽, 黄治国, 李治贵, 麻伟青, 李娜. 超声引导下右美托咪定作为佐剂的罗哌卡因单次收肌管阻滞用于成人髌骨骨折术后镇痛的效果, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220613
[5]	姚璐, 谭慧, 阮永华, 钱忠义, 杨志鸿, 阮锐, 张琦颖, 周明婷, 方星尹. 超声支气管镜引导下的经支气管针吸活检术在肺和纵隔占位性病变诊断中的应用, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20210311
[6]	陈竹梅, 华月英, 温艳艳, 李辉. 行超声引导下PICC置管患者并发症的发生情况及影响因素, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20210209
[7]	韦琳, 冯煜然, 袁惠, 周科宇, 赵诣, 钱军, 朱梅. 超声引导下甲状腺结节细针穿刺活检的6种操作方法的比较, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20211044
[8]	王兴耀, 钱金桥. 超声引导单点和双点椎旁神经阻滞在胸腔镜术患者的镇痛比较, 昆明医科大学学报.
[9]	陶建平, 屈启才, 周臣, 李冠菲, 邵明琨, 夏丽滨. 超声引导下髂总动脉阻断联合氨甲环酸预防前置胎盘产后出血, 昆明医科大学学报.
[10]	高静, 李英华, 袁媛, 吴仕葱. 超声引导下微波消融术治疗甲状腺良性结节临床效果, 昆明医科大学学报.
[11]	刘明敏, 王丽春, 梁喜, 杨蕊. 超声引导下乳腺微小病变活检应用于乳腺癌早期诊断, 昆明医科大学学报.
[12]	李星, 梁红敏, 朱梅, 何敏, 曹维涵. 超声引导下星状神经节阻滞治疗失眠症疗效和安全性评价, 昆明医科大学学报.
[13]	乔飞, 汪珺, 展希, 杨文燕. 超声引导下椎旁阻滞在开胸手术后镇痛的临床应用, 昆明医科大学学报.
[14]	张灿华, 钱金桥. 超声引导下外周神经阻滞麻醉对老年人下肢骨科术后功能恢复的影响, 昆明医科大学学报.
[15]	张灿华. HC可视喉镜联合纤维光导支气管镜引导全身麻醉气管插管, 昆明医科大学学报.
[16]	周臣. 超声雾化联合纤支镜表麻用于清醒气管插管的临床观察, 昆明医科大学学报.
[17]	王栋. 不同表面麻醉方法用于纤维支气管镜引导清醒气管插管的效果观察, 昆明医科大学学报.
[18]	张涛. 彩色多普勒超声引导下经皮肾囊肿穿刺硬化治疗疗效分析, 昆明医科大学学报.
[19]	. 右美托咪定对抑制经鼻气管插管反应的临床观察, 昆明医科大学学报.
[20]	. 丙泊酚复合全麻加气管表面麻醉用于声带手术的临床观察, 昆明医科大学学报.