Objective To determine whether the myotoxic side effects of statin simvastatin affect skeletal muscle’s sensitivity to caffeine and halothane. Methods Primary cultured neonate rat skeletal myotubes were treated with 0.01-5.0 μmol/L simvastatin for 48 hours. MTT was used to evaluate cellular viability. The gross morphology and microstructure of the myotubes were observed with a light and electron microscope, respectively. The intracellular calcium concentrations([Ca 2+ ]i) at rest and in response to caffeine and halothane were investigated by fluorescence calcium imaging. Data were analyzed by analysis of variance（ANOVA） test. Results Simvastatin（0.01-5.0 μmol/L） decreased myotube viability, changed their morphological features and microstructure, and increased the resting [Ca 2+ ]i in a dose-dependent manner. Simvastatin did not change myotube’s sensitivity to low doses of caffeine（0.625-2.5 mmol/L） or halothane（1.0-5.0 mmol/L）. In response to high-dose caffeine（10.0 mmol/L, 20.0 mmol/L） and halothane（20.0 mmol/L, 40.0 mmol/L）, myotubes treated with 0.01 μmol/L simvastatin showed a significant increase in sensitivity, but those treated with 1.0 μmol/L and 5.0 μmol/L simvastatin showed a significant decrease. The sarcoplasmic reticulum Ca 2+ storage peaked in the myotubes treated with 0.01 μmol/L simvastatin, but it decreased when cells were treated with higher doses of simvastatin（0.1-5.0 μmol/L）.Conclusions The myotoxic side effect of simvastatin was found to change the sensitivity of myotubes in response to high-dose caffeine and halothane. When dose was low, sensitivity increased mainly because of increased Ca 2+ content in the sarcoplasmic reticulum, which might explain why some individuals with statin-induced myotoxic symptoms may show positive caffeine-halothane contracture test results. However, when the dose was high and the damage to the myotubes was severer, sensitivity was lower. It is here supposed that the damage itself might put individuals with statin-induced myotoxic symptoms at greater risks of presenting with rhabdomyolysis during surgery or while under anesthesia.

Chronic post-surgical pain (CPSP) is a normal and significant symptom in clinical surgery, such as breast operation, biliary tract operation, cesarean operation, uterectomy and thoracic operation. Severe chronic post-surgical pain could increase post-surgical complications, including myocardial ischemia, respiratory insufficiency, pneumonia and thromboembolism. However, the underlying mechanism is still unknown. Herein, a rat CPSP model was produced via thoracotomy. After surgery, in an initial study, 5 out of 12 rats after surgery showed a significant decrease in mechanical withdrawal threshold and/or increase in the number of acetone-evoked responses, and therefore classified as the CPSP group. The remaining seven animals were classified as non-CPSP. Subsequently, open-chest operation was performed on another 30 rats and divided into CPSP and non-CPSP groups after 21-day observation. Protein expression levels in the dorsal spinal cord tissue were determined by 12.5 % SDS-PAGE. Finally, differently expressed proteins were identified by LC MS/MS and analyzed by MASCOT software, followed by Gene Ontology cluster analysis using PANTHER software. Compared with the non-CPSP group, 24 proteins were only expressed in the CPSP group and another 23 proteins expressed differentially between CPSP and non-CPSP group. Western blot further confirmed that the expression of glutaminase 1 (GLS1) was significantly higher in the CPSP than in the non-CPSP group. This study provided a new strategy to identify the spinal proteins, which may contribute to the development of chronic pain using differential proteomics, and suggested that GLS1 may serve as a potential biomarker for CPSP.

AimPreoperative anxiety in children is largely dependent on age and is influenced by anxiety level in parents. The current study compared the level of preoperative anxiety in preschool children versus school‐aged children and its relationship with the state and trait anxiety of the parents.MethodsThis study included 54 preschool children (2–5 years of age) and 48 school‐age children (6–12 years) scheduled to receive ear, nose and throat, plastic or ophthalmologic surgeries. Preoperative anxiety of children was assessed in the holding area immediately prior to the surgery using a modified Yale Preoperative Anxiety Scale (m‐YPAS). Compliance with anaesthesia induction was assessed using an Induction Compliance Checklist (ICC). The state and trait anxiety of the parent who accompanied the child was assessed using a State‐Trait Anxiety Inventory (STAI) questionnaire.ResultsBoth m‐YPAS and ICC scores were higher in preschool children than in school‐age children with significant correlation between the two measures. The STAI‐S score of parents was higher in the preschool group than in the school‐age group. No significant difference was found in STAI‐T score between the two age groups. Children's m‐YPAS score correlated with parental STAI‐T score in both groups (rho = 0.297, P = 0.029 and rho = 0.338, P = 0.019, respectively) but only with STAI‐S score in the preschool group (rho = 0.400, P = 0.003).ConclusionsBoth preschool children and their parents are more anxious than school‐age dyads prior to surgery. The anxiety level of the children correlates with state anxiety of the parents in preschool children but not in school‐age children.

PHEOCHROMOCYTOMAS ARE catecholamine-secreting tumors that typically arise in the medulla of the adrenal gland and sympathetic ganglia. When these tumors are found outside the adrenal gland, they are termed ''paragangliomas''. Cardiac paraganglioma is extremely rare in extra-adrenal locations, accounting for 0.3% of all mediastinal neoplasms, 1 Huo J.L. Choi J.C. DeLuna A. et al. Cardiac paraganglioma: Diagnostic and surgical challenges. J Card Surg. 2012; 27: 178-182 Crossref PubMed Scopus (13) Google Scholar and coexistence of multiple paragangliomas is rarer still. The catecholamine-secreting attribute of the neoplasms may lead to significant hemodynamic fluctuations during resection surgery, thereby increasing the risks of perioperative morbidity and mortality. About 60 of these types of resections have been reported worldwide. 2 Hu M. Pan T. Wei X. et al. A completely resected paraganglioma arising from the right atrioventricular groove. Ann Thorac Surg. 2013; 96: e137-e139 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar However, there are no known reports describing effective treatment of circulatory collapse after cardiac paraganglioma resection while other paragangliomas remained unresected. The authors, therefore, report a rescue of unexpected circulatory collapse after cardiac paraganglioma resection with an intra-aortic balloon pump (IABP) and extracorporeal membrane oxygenator (ECMO) treatment while 2 other paragangliomas remained unresected in the patient; this scenario has not been described in the literature to date.

Cardiac pheochromocytoma is relatively rare. Few reports describe the intraoperative and postoperative progression of patients experiencing a life-threatening pheochromocytoma crisis treated with extracorporeal membrane oxygenation (ECMO).A 35-year-old man was referred to our facility for paroxysmal hypertension with a 10-year history of sweating, headaches, cardiac palpitations, and postexercise dyspnea. The patient initially underwent urine catecholamine measurement and an isotope scan, somatostatin receptor scintigraphy, and 18F-fluorodeoxyglucose positron emission tomography/computer tomography (CT), which indicated a multiple, cardiac pheochromocytoma. Echocardiography, cardiac magnetic resonance imaging (MRI), CT reconstruction, and a coronary CT angiography revealed several lesions at the aortic root and along the cardiac vasculature.Multifocal cardiac pheochromocytoma was diagnosed and pheochromocytoma crisis with severe cyclic blood pressure fluctuation occurred during surgery.Surgical resection of multiple pheochromocytomas in the right medial carotid sheath, mediastinum between the main and pulmonary arteries, and between the abdominal aorta and inferior vena artery was performed. To ensure cardiac perfusion and avoid severe circulatory fluctuation, the cardiac paraganglioma resection was prioritized. After resecting the cardiac pheochromocytoma, a severe pheochromocytoma crisis with rapid cyclic blood pressure fluctuation developed. ECMO and intraaortic balloon pump (IABP) were initiated to stabilize circulation and perfusion. Phenoxybenzamine, norepinephrine, epinephrine, and fluid resuscitation were administered to support cardiovascular function.The magnitude of blood pressure fluctuation steadily decreased with treatment. IABP was discontinued after 3 days, and ECMO was discontinued after 16 days. The patient was discharged 3 months postoperatively.This case indicates that mechanical life support with ECMO is a valuable option for pheochromocytoma-induced cardiac shock and should be considered as an effective therapeutic choice in patients with highly unstable hemodynamic function.

Objective To evaluate the topical anesthetic effects of compound lidocaine cream ( CLC) coated endo-tracheal tube on the prevention of cough/agitation during extubation in thyroidectomy under general anesthesia . Methods 42 patients scheduled for thyroidectomy in Peking Union Medical College Hospital were continuously en -rolled in this prospective double-blinded randomized controlled trial .Patients were randomized into two groups . Group L were intubated with endotracheal tube coated with CLC , while the control group , group C with liquid par-affin .The end point of study was spontaneous or induced cough /agitation during extubation .Hemodynamic parame-ters and the consumption of opioids were recorded .Patients were followed for major complications during their stay in hospital .Results Spontaneous cough/agitation rate was lower in group L than group C ( 15% vs 65%, P<0.01 );so was induced cough/agitation (35%vs 90%, P<0.001 );the value of SBP ×HR was lower in group L&nbsp;at 1 min after extubation ( P<0.05 ) .Conclusions The topical anesthetic effects of CLC coated endotracheal tube could prevent cough and agitation during extubation in thyroidectomy under general anesthesia .

目的 总结近10年北京协和医院手术切除嗜铬细胞瘤麻醉手术经验.方法 北京协和医院1992-09-01-2012-08-31期间手术切除嗜铬细胞瘤461例,按照病历尾号随机采样307例进行回顾性分析.2002-09-01-2012-08-31手术治疗234例作为试验组;1992-09-01-2002-08-31手术治疗73例作为对照组.重点关注术前准备时间、麻醉管理、术中脏器损伤、术后ICU停留时间和术后住院时间等与围术期预后相关的指标近10年的变化.结果 近10年,腹腔镜手术切除嗜铬细胞瘤成为主要手术方式(84.1％),术前准备时间缩短8.9d,引流管拔除时间缩短3.4d,ICU停留时间缩短3d,术后平均住院日缩短8.4 d(P＜0.01).结论 围术期优化治疗策略,可以明显改善嗜铬细胞瘤切除术围术期预后.

Objective To evaluate the effects of different sequences of intravenous administration on fentanyl-induced cough during induction of general anesthesia.Methods One hundred patients of both sexes,aged 18-70 yr,weighing 42-88 kg,of ASA physical status Ⅰ or Ⅱ,scheduled for elective surgery under general anesthesia,were equally randomized to 2 groups using a random number table:fentanyl-propofol group (group FP) and propofol-fentanyl group (group PF).In FP group,fentanyl 3 μg/kg was injected intravenously over 3 s,and then propofol 1.5 mg/kg was injected intravenously.In PF group,propofol 1.5 mg/kg was injected intravenously,and then fentanyl 3μg/kg was injected intravenously over 3 s.The development,intensity and onset time of cough were recorded within 1 min after fentanyl injection.Results Compared with FP group,the incidence of cough was significantly decreased,and no significant change was found in the intensity and onset time of cough in PF group.Conclusion Administration in the propofol-fentanyl sequence can reduce the development of fentanyl-induced cough as compared with that in the fentanyl-propofol sequence during induction of general anesthesia.

Objective To explore whether maintaining low dose remifentanil target controlled infusion(TCI)during emergence from general anesthesia can improve the quality of recovery profiles for the patients under total intrave-nous anesthesia with propofol and remifentanil. Methods Forty elective scoliosis surgical patients were randomized into two groups:control group(n = 20,all anesthetic drugs paused during emergence)and remifentanil group(n = 20,maintaining low dose remifentanil target controlled infusion while propofol infusion paused during emer-gence). Awake time,tracheal extubation time and quality score of recovery status were recorded. Results Awake time and tracheal extubation time were(12. 76 ± 3. 56)min and(13. 98 ± 4. 06)min respectively in control group, while it were(13. 14 ± 3. 87)min and(14. 21 ± 4. 77)min respectively in remifentanil group. There was no signifi-cant difference of awake and tracheal extubation time between two groups. However,the patient number with quali-ty score of recovery status 1 /2 /3 /4 /5 in control group were 1 /10 /5 /3 /1 respectively,while it were 5 /12 /3 /0 /0 respectively in remifentanil group(P 0. 05). Conclusions Maintaining low dose remifentanil target controlled infusion during emergence from general anesthesia can improve recovery quality and does not prolong awake time and tracheal extubation time for the patients under total intravenous anesthesia with propofol and remifentanil.

Objective Anti-N-methyl-D-Aspartate (NMDA) receptor encephalitis is a rare disease,recently described as autoimmune disorder of paraneoplastic limbic encephalitis,which is related to the NMDA receptor antibodies and frequently develops in young women with ovarian teratoma.The disease is usually accompanied by symptoms of psychosis and abnormal behaviors,autonomic nervous system dysfunction,central hypoventilation,and hyperthermia.During induction and maintenance of general anesthesia,we should be aware of adverse reactions such as cardiovascular events,hyperthermia and respiratory insufficiency.In order to maintain vital signs stable,pharmacological agents including vasopressors,β-blockers,antihypertensives,and anticholinergics should be prepared before the surgery.Invasive monitoring for blood pressure can be set if necessary.This study described the method for anesthetic management of 3 patients with anti-NMDA receptor encephalitis undergoing resection of ovarian teratoma under general anesthesia.Preoperative treatment included antipsychotic,anti-infective and immune therapy.General anesthesia was induced with propofol,rocuronium,fentanyl and midazolam to facilitate tracheal intubation and was maintained with inhalation of sevoflurane (mixed with oxygen and air) and intermittent iv boluses of fentanyl and rocuronium during the surgery.All the drugs mentioned above had no interaction or had slight indirect action on anti-NMDA receptors to avoid NMDA-related adverse reactions.In conclusion,the adequate preparation for the surgery should be done in this kind of patients,we should avoid using anesthetics having NMDA receptor antagonism (such as ketamine,N2O,methadone,dextromethorphan,phencyclidine) or other anesthetics acting indirectly (such as pentobarbital) on the NMDA receptors during anesthetic management in the patients with anti-NMDA receptor encephalitis.

Objective To evaluate the effect of gabapentin for treatment of neuropathic pain induced by bilateral sciatic nerve chronic constriction injury (bCCI) of rats.Methods Forty-eight female SPF Sprague-Dawley rats,weighing 180-200 g,aged 7-9 weeks,were randomly divided into 4 groups (n =12 each) using a random number table:control group (C group),sham operation group (S group),bCCI group,and bCCI + gabapentin group (G group).Gabapentin 100 mg/kg was intraperitoneally injected once at 15 min before operation and twice a day during 7-13 days after operation for 7 consecutive days.The bilateral mechanical paw withdrawal threshold (MWT),thermal paw withdrawal latency (TWL) and number of cold-stimulated paw withdrawal were measured before operation (baseline) and at 1,3,6,8,10,14 days after operation.Results Compared with C group,the bilateral MWT was significantly decreased,and the bilateral TWL was shortened in bCCI and G groups,and no significant change was found in MWT and TWL in S group.Compared with bCCI group,the bilateral MWT was significantly increased,the bilateral TWL was prolonged,and no significant change was found in the number of cold-stimulated paw withdrawal in G group.Conclusion Gabapentin can relieve thermal and mechanical hyperalgesia induced by bCCI,however,it exerts no effect on cold allodynia in rats.

Objective To compare the differences in glottis exposure,success rate of intubation and resulting complications, in airway intubation with 2 portable video laryngoscopes and the Macintosh laryngoscope under general anesthesia. Methods Ninety ASA grade Ⅰand Ⅱpatients receiving selective airway intubation under general anesthesia were randomly assigned to 2 groups. Following general anesthesia and with classical airway intubation methods,first the Macintosh laryngoscope was used to expose and view the glottis,then intubation procedures were completed under the video laryngoscopes. Grades of glottis exposure view,number of attempts of intubation,ease of intubation and resulting complications were monitored and recorded. Results Compared with the Macintosh laryngoscope,both the Yi-an and the McGrath video laryngoscopes provided significantly much better view in glottis exposure( 27 /45: 29 /45,P 0. 05). There were no statistically significant differences in the improvement of view,the ease and success rate of intubation,when comparisons were made between the two video laryngoscopes( P 0. 05). Conclusion Both video laryngoscopes could provide a superior view of glottis,facilitating easier intubation,when compared with the Macintosh laryngoscope,however,complications induced by airway intubation could not be avoided.

Objective To investigate the effects of isoflurane anesthesia on β-amyloid protein (Aβ) generation and phosphorylation of c-Jun N-terminal kinase (JNK) and cyclic AMP responsive element binding protein (CREB) in the hippocampus of aged rats.Methods Ninety-six male Sprague-Dawley rats,aged 18 months,weighing 450-500 g,were randomly divided into control group (group C,n =24),1％ isoflurane anesthesia group (group S1,n =36) and 2 ％ isoflurane anesthesia group (group S2,n =36).Groups S1 and S2 inhaled 1％ and 2％ isoflurane for 4 h,respectively.Twelve rats were chosen in each group and Morris water maze was performed 1 day after anesthesia.Twelve rats in each group were chosen on day 1 and 7 after anesthesia (T1,T7) and open field test was performed.The rats were sacrificed after open field test and hippocampi were isolated for determination of the expression of Aβ,phosphorylated JNK (p-JNK) and phosphorylated CREB (p-CREB) in hippocampal tissues by Western blot.Results Compared with group C,the escape latency was significantly prolonged and target quadrant dwell time ratio was decreased significantly in groups S1 and S2,the total movement distance,leave border distance and inner toroid distance were prolonged,Aβ expression was up-regulated,and p-CREB expression was down-regulated at T1 and leave border distance and inner toroid distance were prolonged,Aβ expression was up-regulated at T7 in group S1,and the total movement distance,faster movement distance,leave border distance and inner toroid distance were prolonged,the expression of Aβ and p-JNK was up-regulated,and p-CREB expression was down-regulated at T1,and the total movement distance,faster movement distance,leave border distance and inner toroid distance were prolonged,the expression of Aβ was up-regulated at T7 in group S2 (P ＜ 0.05 or 0.01).Conclusion The mechanism by which isoflurane anesthesia induces cognitive dysfunction is related to promotion of Aβ generation and JNK activation and inhibition of CREB activation in the hippocampus of aged rats.

Objective To investigate the relationship between perioperative nocturnal melatonin and cortisol levels and the sleep disturbances in elderly patients.Methods This was a prospective observational case control study.Thirty two 65yr and older inpatients that would receive lower extremity joint replacement or peripheral vascular surgery were enrolled into two patient groups,general anesthesia group(group GA: n =16) and regional anesthesia group(group RA: n =16).Sixteen healthy volunteers at the same age came from community inhabitants were enrolled as a control group(group C: n = 16).Consecutively four days' 12h(8 pm ~ 8 am) nocturnal urine samples were collected from everyone,but all patients were asked to collect urine samples since the preoperative night.The melatonin sulfate and cortisol concentration of the urine samples were determined by ELISA kits and RIA kits respectively.Simple sleep disorder questionnaires were used to evaluate the sleep qualities every morning during the observation.Results Compared with group C,the perioperative nocturnal urine melatonin levels were decreased significantly in group GA and RA(P < 0.01).The preoperative nocturnal urine cortisol levels showed no difference in 3 groups,but it was elevated significantly postoperatively in group GA and RA(P < 0.01).The nocturnal urine melatonin level had a significant correlation with sleep disorders(r = 0.8574,P < 0.01).The cortisol level also had a correlation with sleep disorders(r = 0.2667).Conclusion In elderly surgical patients,the nocturnal urine melatonin levels are decreased preoperatively,while the cortisol levels are increased postoperatively.The decreased melatonin level may be a reason of postoperative sleep disorders.

目的 观察老年患者手术前后褪黑素、皮质醇分泌水平的变化及与睡眠紊乱的关系.方法 采用前瞻性病例对照研究的方法:病例组选择32例ASAⅡ～Ⅲ级65岁以上行择期下肢关节或外周血管手术患者,按麻醉方式分为全身麻醉组(n=16)与区域麻醉组(n=16),留取术前ld及术后连续4d夜间12h(晚上20点至次日8点)尿标本；对照组选择16例65岁以上的健康志愿者,均为非夜班工作的社区居民,留取连续4d夜间12 h尿标本.使用睡眠紊乱调查表评估观察期间每晚的睡眠质量(睡眠紊乱评分:0 ～5).用ELISA法测定尿硫酸褪黑素浓度,RIA法测定尿皮质醇浓度,计算每人每天夜间的褪黑素、皮质醇分泌量.结果 与对照组相比,全身麻醉组与区域麻醉组患者术前ld及术后前3d夜间褪黑素水平显著降低(P＜0.01)；术前ld夜间皮质醇水平3组间差异无统计学意义,术后夜间皮质醇水平病例组均显著升高(P＜0.01).夜间褪黑素水平与睡眠紊乱评分显著相关(r=0.8574,P＜0.01),夜间皮质醇水平与睡眠紊乱评分也有一定相关性(r=0.2667).结论 老年手术患者围术期夜间褪黑素水平普遍降低,皮质醇水平术后普遍升高,褪黑素水平下降可能是造成睡眠紊乱的重要原因.

术后镇痛的必要性和地佐辛的临床药理 手术后疼痛是手术导致的组织损伤所引起的不愉快的感觉和情感体验,中到重度疼痛通常伴有机体各系统,如呼吸、循环、消化、泌尿等系统功能不良,也导致内分泌、代谢、免疫、心理和精神障碍.手术后疼痛常在手术后或麻醉作用消失后即刻发生,通常不超过3～7 d,其性质为伤害性疼痛.术后痛控制不良也可能是转变为术后持续性疼痛的主要原因,术后持续性疼痛有神经病理性疼痛的相似机制.

OBJECTIVE To evaluate the influence of different tranexamic acid administration methods during and after cardiac surgery with cardiopulmonary bypass(CPB) on coagulation function and postoperative bleeding. METHODS Patients undergoing elective cardiac surgery with use of CPB (n=60) were randomized in a double-blind fashion to one of two treatment groups:group A(n=30) , administered with tranexamic acid 10 mg/kg (intravenous injection slowly before skin incision) , followed by infusion of normal saline until postoperative 12 hours;and group B(n=30) , administered with tranexamic acid 10 mg/kg(intravenous injection slowly before skin incision) , followed by infusion of tranexamic acid 1 mg/(kg·h) until postoperative 12 hours. Hemoglobin, platelet count, and coagulation function were assessed before anesthesia induction, after surgery, 8am next day and 24 hours after surgery. Bleeding, allogeneic blood transfusion, and fluid infusion during the postoperative 24 hours were recorded. RESULT No differences were found between groups in terms of coagulant function, postoperative bleeding, allogeneic blood transfusion, and fluid infusion(P>0.05) . CONCLUSION Compared with intraoperative administration alone, prolonged treatment with tranexamic acid after cardiac surgery shows no advantage because it can not further improve coagulant function, reduce bleeding, or reduce allogeneic blood transfusion.

BACKGROUND:Surveys suggest that, consistent with a high smoking prevalence, Chinese smokers in the general population report little interest in quitting. In other cultures, surgery is a powerful teachable moment for smoking cessation, increasing the rate of spontaneous quitting. We determined the perioperative tobacco use behavior of Chinese patients scheduled for elective surgery who smoke cigarettes and factors associated with both preoperative intent to abstain and self-reported smoking behavior at 30 days postoperatively. Specifically, we tested the hypothesis that perception of the health risks of smoking would be independently associated with both preoperative intent to abstain and self-reported abstinence at 30 days postoperatively. METHODS:Patients ≥18 years of age scheduled for elective noncardiovascular surgery at Peking Union Medical College Hospital in Beijing, China, were assessed preoperatively and up to 30 days postoperatively for factors associated with smoking behavior, including indices measuring knowledge of smoking-related health risks. RESULTS:Of the 227 patients surveyed at baseline, most (164, 72%) intended to remain abstinent after hospital discharge. For the 204 patients contacted at 30 days postoperatively, 126 (62%) self-reported abstinence. In multivariate analysis, factors associated with preoperative intent to abstain after surgery included older age, self-efficacy for abstaining, and undergoing major surgery; factors associated with abstinence included older age, self-efficacy, major surgery, and preoperative intent to abstain. Higher perception of benefits from quitting was associated with intent, but not abstinence. Knowledge of the health risks caused by smoking was not found to be associated with either intent or abstinence, so that the hypothesis was not supported. CONCLUSIONS:Both intent to quit and self-efficacy for maintaining abstinence appear to be much higher in Chinese surgical patients than in prior surveys of the general Chinese population, and the majority of surgical patients maintained abstinence for at least 30 days. These findings suggest that surgery can serve as a powerful teachable moment for smoking cessation in China.

<正>困难气管插管是麻醉医师经常面对的挑战。造成插管困难的主要原因之一是声门暴露困难[1],据报道声门暴露为Cormark-Lehane分级Ⅱb以上患者发生困难插管的概率可达67.4%[2]。Airtraq喉镜是新型的一次性使用可视喉镜