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Abstract：
OBJECTIVE: To determine whether there is a clinically relevant difference between the circulatory responses to double-lumen tube intubation (DLTI) with the GlideScope video laryngoscope versus the Macintosh direct laryngoscope.
METHODS: Eighty adult patients requiring double-lumen tubes for thoracic surgery were randomly and equally allocated to either a Macintosh direct laryngoscope group (DL group, n = 40) or a Glide Scope video laryngoscope group (GS group, n = 40). DLTI was performed after airway evaluations and induction of anesthesia. Systolic blood pressure (SBP) and heart rate (HR) were recorded before induction (baseline values), immediately before intubation (post-induction values), at intubation and after intubation. Rate-pressure-product (RPP), and the areas under SBP- and HR-time curves were calculated. All data obtained by the two devices were compared.
RESULTS: After laryngoscope insertion, SBP of DL and GS groups changed significantly differently (13.1% vs. 4.6%, P< 0.001), while HR changed similarly (17.2% vs. 14.6%, P = 0.074). One minute after intubation, both SBP and HR significantly increased in both groups (SBP: 11.6% vs. 11.9%; HR: 18.4% vs. 10.8%), but there were no significant differences between the two groups. RPP significantly increased in both groups after laryngoscope insertion (32.6%, P=0.001; 18.2%, P=0.002), and there was a significant difference between the two groups (P =0.001). Throughout intubation, the areas under SBP-time curves had a significant difference between the two groups (P = 0.042), while those under HR-time curves did not differ significantly (P=0.06).
CONCLUSIONS: The intubation response was most significant upon laryngoscope insertion during the whole intubation process. The GlideScope video laryngoscope induced milder circulatory fluctuations than the Macintosh direct laryngoscope did, suggesting that DLTI using video laryngoscopy can help reduce the cardiovascular response to intubation.
METHODS: Eighty adult patients requiring double-lumen tubes for thoracic surgery were randomly and equally allocated to either a Macintosh direct laryngoscope group (DL group, n = 40) or a Glide Scope video laryngoscope group (GS group, n = 40). DLTI was performed after airway evaluations and induction of anesthesia. Systolic blood pressure (SBP) and heart rate (HR) were recorded before induction (baseline values), immediately before intubation (post-induction values), at intubation and after intubation. Rate-pressure-product (RPP), and the areas under SBP- and HR-time curves were calculated. All data obtained by the two devices were compared.
RESULTS: After laryngoscope insertion, SBP of DL and GS groups changed significantly differently (13.1% vs. 4.6%, P< 0.001), while HR changed similarly (17.2% vs. 14.6%, P = 0.074). One minute after intubation, both SBP and HR significantly increased in both groups (SBP: 11.6% vs. 11.9%; HR: 18.4% vs. 10.8%), but there were no significant differences between the two groups. RPP significantly increased in both groups after laryngoscope insertion (32.6%, P=0.001; 18.2%, P=0.002), and there was a significant difference between the two groups (P =0.001). Throughout intubation, the areas under SBP-time curves had a significant difference between the two groups (P = 0.042), while those under HR-time curves did not differ significantly (P=0.06).
CONCLUSIONS: The intubation response was most significant upon laryngoscope insertion during the whole intubation process. The GlideScope video laryngoscope induced milder circulatory fluctuations than the Macintosh direct laryngoscope did, suggesting that DLTI using video laryngoscopy can help reduce the cardiovascular response to intubation.
摘要：
目的：确定GlideScope视频喉镜与Macintosh直接喉镜对双腔插管（DLTI）的循环反应是否存在临床相关差异。
方法：将80名需要双腔管进行胸外科手术的成年患者随机平均分配到Macintosh直接喉镜组（DL组，n=40）或GlideScope视频喉镜组（GS组，n=40)。在气道评估和麻醉诱导后进行DLTI。记录诱导前收缩压（SBP）和心率（HR）（基线值），插管前（诱导后的值），插管时和插管后。速率-压力-乘积(RPP),并计算SBP和HR时间曲线下的面积。比较由两个装置获得的所有数据。
结果：喉镜插入后，DL和GS组的SBP变化显着不同（13.1%vs.4.6%,P<0.001)，而HR变化相似(17.2%与14.6%,P=0.074）。插管后一分钟,两组的SBP和HR均显着增加（SBP：11.6％vs.11.9%；HR：18.4%与10.8%），但两组间无显著差异。喉镜插入后两组的RPP均显着增加（32.6％，P=0.001；18.2%，P=0.002),两组间差异有统计学意义(P=0.001)。在整个插管过程中，SBP-时间曲线下面积在两组间有显著性差异(P=0.042),而HR-时间曲线下的那些没有显着差异（P=0.06）。
结论：在整个插管过程中，喉镜插入时插管反应最为显著。GlideScope视频喉镜比Macintosh直接喉镜引起的循环波动更温和，提示使用视频喉镜检查的DLTI可以帮助减少心血管对插管的反应。
方法：将80名需要双腔管进行胸外科手术的成年患者随机平均分配到Macintosh直接喉镜组（DL组，n=40）或GlideScope视频喉镜组（GS组，n=40)。在气道评估和麻醉诱导后进行DLTI。记录诱导前收缩压（SBP）和心率（HR）（基线值），插管前（诱导后的值），插管时和插管后。速率-压力-乘积(RPP),并计算SBP和HR时间曲线下的面积。比较由两个装置获得的所有数据。
结果：喉镜插入后，DL和GS组的SBP变化显着不同（13.1%vs.4.6%,P<0.001)，而HR变化相似(17.2%与14.6%,P=0.074）。插管后一分钟,两组的SBP和HR均显着增加（SBP：11.6％vs.11.9%；HR：18.4%与10.8%），但两组间无显著差异。喉镜插入后两组的RPP均显着增加（32.6％，P=0.001；18.2%，P=0.002),两组间差异有统计学意义(P=0.001)。在整个插管过程中，SBP-时间曲线下面积在两组间有显著性差异(P=0.042),而HR-时间曲线下的那些没有显着差异（P=0.06）。
结论：在整个插管过程中，喉镜插入时插管反应最为显著。GlideScope视频喉镜比Macintosh直接喉镜引起的循环波动更温和，提示使用视频喉镜检查的DLTI可以帮助减少心血管对插管的反应。
