2026 年第 10 期 第 21 卷

BlockBuster喉罩和直接喉镜气管插管对老年全身麻醉患者血压的影响

Effects of BlockBuster laryngeal mask airway versus direct laryngoscope tracheal intubation on blood pressure in elderly patients undergoing general anesthesia

作者：胡振伐苏凯高学田鸣

英文作者：Hu Zhenfa Su Kai Gao Xue Tian Ming

单位：首都医科大学附属北京友谊医院麻醉科，北京100050

英文单位：Department of Anesthesiology Beijing Friendship Hospital Capital Medical University Beijing 100050 China

关键词：BlockBuster喉罩；直接喉镜；气管插管；老年患者；全身麻醉

英文关键词：BlockBusterlaryngealmaskairway;Directlaryngoscope;Trachealintubation;Elderlypatients;Generalanesthesia

• 摘要：

• 目的  观察经BlockBuster喉罩与直接喉镜气管插管患者的血压变化、成功率及插管时间，评价经BlockBuster喉罩气管插管在老年患者全身麻醉中的应用效果。方法 选取2022年6—12月首都医科大学附属北京友谊医院拟在全身麻醉下行择期手术的老年患者62例作为研究对象。2例患者中途退出试验，最终纳入60例患者，按随机数字表法分为BlockBuster喉罩组和经直视喉镜组，每组30例。BlockBuster喉罩组患者待麻醉诱导下颌松弛后置入BlockBuster喉罩，电子视频软镜检查声门位置后再经喉罩盲探气管插管；经直视喉镜组患者麻醉诱导5 min后使用直接喉镜气管插管。观察并记录2组患者麻醉诱导前、置入喉罩或喉镜时、气管插管即刻、气管插管后1 min、3 min、5 min的收缩压、舒张压、平均动脉压和心率；气管插管的次数及成功率，气管插管时间，有效气道建立时间；不良反应发生情况。结果 BlockBuster喉罩组有效气道建立时间短于经直视喉镜组［（18±4）s比（22±4）s］，插管时间长于经直视喉镜组［（48±11）s比（22±4）s］，差异均有统计学意义（均P<0.001）。插入喉罩或置入喉镜时，BlockBuster喉罩组收缩压、舒张压、平均动脉压和心率均显著低于经直视喉镜组（均P＜0.05）；与麻醉诱导前比较，经直视喉镜组插管期间心率均显著增加，BlockBuster喉罩组血压和心率均明显降低（均P＜0.05）。2组患者均未出现严重不良反应事件。结论 经BlockBuster喉罩气管插管患者血压波动较小，插管成功率与喉镜相似，尽管平均插管时间长，但建立有效气道的平均时间短。

• Objective To observe the changes in patients′ blood pressure, success rate and intubation time of tracheal intubation via BlockBuster laryngeal mask airway and direct laryngoscope, and to evaluate the application effect of BlockBuster laryngeal mask airway tracheal intubation in elderly patients under general anesthesia. Methods A total of 62 elderly patients scheduled for elective surgery under general anesthesia in Beijing Friendship Hospital, Capital Medical University from June to December 2022 were enrolled. Two patients dropped out midway, and finally 60 patients were included and randomly divided into BlockBuster laryngeal mask airway group and direct laryngoscope group, with 30 cases in each group. In the BlockBuster group, the BlockBuster laryngeal mask airway was inserted after mandibular relaxation following anesthesia induction, and blind tracheal intubation was performed through the laryngeal mask after glottis location was confirmed by electronic video flexible endoscopy. In the direct laryngoscope group, tracheal intubation was performed using a direct laryngoscope 5 min after anesthesia induction. Systolic blood pressure, diastolic blood pressure, mean arterial pressure and heart rate were recorded before anesthesia induction, at the time of laryngeal mask or laryngoscope placement, immediately after intubation, and at 1 min, 3 min and 5 min after intubation. The intubation attempts and success rate, intubation time, time to establish effective airway and adverse reactions were compared between the two groups. Results The time to establish effective airway in the BlockBuster group was shorter than that in the direct laryngoscope group ［(18±4)s vs (22±4)s］, while the intubation time was longer ［(48±11)s vs (22±4)s］(both P<0.001). At the time of laryngeal mask or laryngoscope placement, systolic blood pressure, diastolic blood pressure, mean arterial pressure and heart rate in the BlockBuster group were significantly lower than those in the direct laryngoscope group (all P＜0.05). Compared with baseline before induction, the heart rate increased significantly during intubation in the direct laryngoscope group, while blood pressure and heart rate decreased obviously in the BlockBuster group (all P＜0.05). No severe adverse events occurred in either group. Conclusion Tracheal intubation via BlockBuster laryngeal mask airway causes less hemodynamic fluctuation, with a similar intubation success rate compared with direct laryngoscope. Although the average intubation time is longer, the time to establish effective airway is shorter.