Abstract: Objective To investigate the clinical effect of sevoflurane inhalation induction and UE glidescope under spontaneous breathing in patients with anticipated difficult airway. Methods Fifty ASA Ⅰ-Ⅲ patients with difficult airway scheduled for tracheal intubation anesthesia were selected. All patients were induced with inhalation of 8% sevoflrane and oxygen 6 litre min^-1 under spontaneous breathing via face masks, and then intubated by UE glidescope. The mean arteriablood pressure （MAP）, heart rate （HR） and O₂ saturation （SpO₂） were recorded at the time points of T₁ （before anesthesia）, T₂ （before intubation） and T3 （after intubation）. The intubation times, the first-attempt success rate of intubation and the related adverse events were recorded. Results During the whole procedure of induction and intubation, SpO₂ was more than 96% in all patients. Fourty-three cases （86%） were intubated successfully at first attempt, 4 cases with re-intubated, no case with respiratory suppression, laryngospasm, and bucking, 2 cases with mild teeth bleeding. No significant difference in HR, MAP and SpO₂ at three time points. Conclusion sApplication of sevoflurane inhalation induction combined with UE glidescope intubationin patients with difficult airway not only provides high rate of successful intubation, but also has relative stable hemodynamics and low occurrence rate of adverse events, therefore, which is a safe and feasible induction scheme.

Key words: inhalation induction, UE glidescope, sevoflurane, difficult airway

摘要： 目的 探讨保留自主呼吸条件下七氟醚吸入诱导联合UE可视喉镜在可预料困难气道管理中的应用效果。方法 选择美国麻醉医师协会（ASA）分级Ⅰ~Ⅲ级、术前评估为困难气道的全麻手术患者50例。患者入室后自主呼吸,面罩吸入6 L·min^-1氧气+8%七氟烷,间断辅助利多卡因呼吸道表面局麻,联合UE可视喉镜行气管插管。观察患者诱导前（T₁）、插管前（T₂）、插管后即刻（T₃）3个时间点平均动脉压（MAP）、心率（HR）、脉搏氧饱和度（SpO₂）的变化,记录插管时间和一次性插管成功率及诱导期间相关不良事件发生率。结果 所有患者诱导插管期间SpO₂均稳定在96%以上,无一例出现呼吸抑制。一次性成功插管43例（86%）,二次插管成功4例,插管时间在（136.8±35.2）s,喉痉挛、呛咳等不良反应少,2例出现牙龈少量渗血,血流动力学变化无明显差异。结论 保留自主呼吸条件下七氟醚吸入诱导联合可视喉镜气管插管应用于困难气道管理中插管成功率高、血流动力学平稳、不良反应少,是一种安全可行的麻醉诱导方案。

关键词: 困难气道, UE可视喉镜, 七氟烷, 吸入诱导