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| 超声引导下喉上神经阻滞在清醒经口气管插管中的应用 |
| Efficacy of ultrasound-guided superior laryngeal nerve block for awake orotracheal fiberoptic intubation |
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| DOI： |
| 中文关键词: 超声引导 喉上神经阻滞 清醒气管插管 |
| 英文关键词: Ultrasound-guided Superior laryngeal nerve block Awake fiberoptic intubation |
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| 中文摘要: |
目的：研究超声引导下喉上神经阻滞在清醒经口气管插管中的应用效果。
方法：选择择期行全麻手术, 颈椎活动受限的患者40例, 男23例, 女17例, 年龄18～65岁, ASA Ⅰ或Ⅱ级。按随机数字表法随机分为体表法行喉上神经阻滞组(N组)和超声法行喉上神经阻滞组(D组)。在一定的镇静状态下, N组采用体表解剖法行喉上神经阻滞, D组采用超声引导法行喉上神经阻滞, 复合口咽气管表面麻醉行清醒经口气管插管。记录插管时间, 记录入室后(T0)、气管导管进口腔前(T1)、气管导管进入声门即刻(T2)、插管成功后5 min(T3)的MAP、HR。记录患者Ramsay镇静评分、舒适度和耐受情况, 插管过程中的并发症, 回访患者的满意度。
结果：D组气管插管时间明显短于N组[(0.5±0.1) min vs (1.0±0.2) min,P＜0.05]。与D组比较, T2时N组MAP明显升高, HR明显加快, Ramsay评分明显降低(P＜0.05)。与N组比较,D组插管过程中舒适度评分和耐受性评分明显降低, 患者的满意度评分明显升高, 且插管过程中恶心呕吐、呛咳、体动以及术后咽痛的发生率明显降低(P＜0.05)。
结论：超声引导下喉上神经阻滞能够更好地满足清醒经口气管插管的需要, 起效快且患者的血流动力学稳定, 易于接受且不良反应发生率低。 |
| 英文摘要: |
Objective: To observe the efficacy of the ultrasound-guided superior laryngeal nerve block for awake orotracheal fiberoptic intubation.
Methods: Forty patients with limited cervical activity scheduled for elective surgery under general anesthesia, 23 males and 17 females, aged 18-65 years, ASA physical status Ⅰ or Ⅱ were chosen. According to random number table method, they were randomly divided into two groups (n=20). Group N received superior laryngeal nerve block using the acupoint-located method by anatomical landmark, and group D was under ultrasound-guided, combined with airway anesthesia. Awake orotracheal fiberoptic intubation was then performed. Intubation time and the changes of MAP, HR, Ramsay sedation score were recorded at the time of burglary (T0), before the endotracheal tube into the mouth (T1), endotracheal tube into the glottis immediately (T2), 5 min after intubation (T3). Ramsay score was rated to assess the patients comfort and tolerance, complications during intubation process were documented, the patients satisfaction was received.
Results: Compared with the group N, the intubation time of group D was significantly shorter [(0.5±0.1) min vs (1.0±0.2) min, P＜0.05]. In group N, MAP and HR were obviously higher during intubation with lower Ramsay sedation score at T2 compared with group D (P＜0.05). Patients in group D had lower comfort score and tolerance grade during intubation (P＜0.05). The incidence of nausea, vomiting, restlessness and pharyngalgia were significantly lower in group D (P＜0.05). Besides, patients during intubation in group D were more satisfactory (P＜0.05).
Conclusion: Ultrasound-guided superior laryngeal nerve block for awake orotracheal fiberoptic intubation could provide an ideal sedative effect, maintain stable circulation and keep patients tolerable. |
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