喉上神经阻滞用于经口清醒气管插管的临床疗效分析

目的:探讨喉上神经阻滞用于经口清醒气管插管的临床效果。方法:选取拟于全麻下行择期颈椎手术的患者60例,按随机数字表法分为2组,喉上神经阻滞组(S组,30例)和对照组(C组,30例)。记录2组入室后10 min(T1)、纤支镜通过咽部即刻(T2)、纤支镜通过声门即刻(T3)、气管导管通过声门即刻(T4)4个时间点的脉搏血氧饱和度(SpO_2)、心率(heart rate,HR)、平均动脉压(mean arterial pressure, MAP)以及一次插管成功率、声带活动度、呛咳程度、患者满意度及相关并发症。结果:所有患者均一次性完成气管插管,未出现低氧血症,无相关严重并发症发生。喉上神经阻滞操作时间为(1.29±0.29)min。S组声带活动度、呛咳程度及患者满意度评分均显著优于C组(P0.05)。S组T3、T4时间点MAP和HR均显著低于C组(P0.05)。结论:采用喉上神经阻滞不影响一次插管成功率,能提供更好的清醒气管插管条件,插管过程中声带活动度低,呛咳程度轻,血流动力学更稳定,患者满意度高,且无相关严重并发症发生。

Clinical observational study of superior laryngeal nerve block in awake fibreoptic orotracheal intubation

Objective: To explore the clinical effect of superior laryngeal nerve block in awake fibreoptic orotracheal intubation.Methods: Sixty patients who underwent elective cervical surgery under general anethesia were included. Patients were randomly divided into two groups:superior laryngeal nerve block group (Group S, n=30) and control group (Group C, n=30) according to random number table method. SpO₂, heart rate (HR), and mean arterial pressure (MAP) at four time points were recorded:10 min afer entering the room (T1), fibrobronchoscope through the pharynx (T2), fibrobronchoscope through the glottis (T3), endotracheal tube through the glottis (T4). Rate of one-time success, scores of the vocal cord movement, cough and patient satisfaction, as well as complications were documented.Results: All patients successfully completed the tracheal intubation at one time, and the operation time of superior laryngeal nerve block was (1.29±0.29) min without hypoxemia. The scores of vocal cord movement, cough, and patient satisfaction were significantly better in Group S than those in Group C (P<0.05). Compared with Group C, the MAP and HR in Group S at T3 and T4 were lower (P<0.05). There were no relative complications in the two groups.Conclusions: The superior laryngeal nerve block does not affect the success rate of first-time tracheal intubation, can provide better conditions for awake fibreoptic intubation with alleviated vocal cord activity and cough, and the hemodynamics were more stable during the intubation procedure with high patient''s satisfaction.