Efficacy of ultrasound-guided superior laryngeal nerve block for awake orotracheal fiberoptic intubation / 临床麻醉学杂志

ABSTRACT

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 u-sing 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.Intu-bation time and the changes of MAP,HR,Ramsay sedation score were recorded at the time of bur-glary (T0 ),before the endotracheal tube into the mouth (T1 ),endotracheal tube into the glottis im-mediately (T2 ),5 min after intubation (T3 ).Ramsay score was rated to assess the patients'comfort and tolerance,complications during intubation process were documented,the patient's 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 intuba-tion could provide an ideal sedative effect,maintain stable circulation and keep patients tolerable.