The application effect of ultrasound-guided superior laryngeal nerve block in endotracheal intubation with preserved spontaneous breathing

doi:10.11958/20253015

Abstract

Abstract:

Objective To study the safety and efficacy of ultrasound-guided superior laryngeal nerve block (SLNB) in endotracheal intubation with preserved spontaneous breathing. Methods Sixty patients requiring endotracheal intubation with preserved spontaneous breathing were randomly divided into the ultrasound-guided SLNB group (group L) and the supraglottic airway surface anesthesia group (group C), with 30 cases in each group. Patients in the group L underwent bilateral SLNB under ultrasound guidance with 2% lidocaine. In the group C, 2% lidocaine was used successively for surface anesthesia of the pharynx, palatine tonsils, base of the tongue, epiglottis, piriform crypts and glottis. Both groups underwent surface anesthesia of the trachea through cricothyroid membrane puncture, and 1% tetracaine was selected as the drug. The main observation indicators included the nausea and choking cough scores when the laryngoscope was inserted to the root of the epiglottis (T₂), immediately after the tracheal tube was inserted into the glottis (T₃) and when the tube sleeve was inflated after the tracheal tube entered the trachea (T₄). Secondary observation indicators included changes in mean arterial pressure (MAP), heart rate (HR), vocal cord movement, 3 min after the patient entered the room (T₀), before tracheal intubation (T₁) and after tracheal intubation (T₅). The incidence rates of sore throat score, postoperative nausea and vomiting, hoarseness, hematoma at the puncture site, infection and nerve injury, as well as patient satisfaction were also recorded. Results Compared with the group C, the nausea and choking cough scores were decreased at T₂ and T₃ in the group L (P < 0.05), while there were no statistically significant differences in nausea and choking cough scores between the two groups at T₄ (P > 0.05). There were no significant differences in MAP and HR before and after tracheal intubation between the two groups (P > 0.05). Compared with the group C, the vocal cord activity was more conducive to the operation of tracheal intubation in the group L (P < 0.01). At 24 hours after the operation, the postoperative sore throat score was decreased in patients of the group L (P < 0.01), and the satisfaction score increased (P < 0.05). In the group C, there was one case of postoperative nausea and vomiting. In the group L, there were 2 cases of postoperative nausea and vomiting, 1 case of postoperative hoarseness. There was no significant difference in the incidence of adverse reactions between the two groups (3.3% vs. 10.0%, χ²=1.071, P>0.05). Conclusion The application of SLNB under ultrasound guidance can enhance the safety and effectiveness of patients during the process of endotracheal intubation with preserved spontaneous breathing, relieve nausea, choking cough and postoperative sore throat.

Key words: laryngeal nerves, nerve block, intubation, intratracheal, ultrasound guided, cough, postoperative sore throat

CLC Number:

R614.2

Figures/Tables 6

References 24

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组别	n	年龄/岁	性别（男/女）	BMI/（kg/m²）
C组	30	58.67±9.25	14/16	23.89±3.89
L组	30	57.40±13.64	19/11	24.34±2.20
t或χ²		0.421	1.684	0.658

组别	n	年龄/岁	性别（男/女）	BMI/（kg/m²）
C组	30	58.67±9.25	14/16	23.89±3.89
L组	30	57.40±13.64	19/11	24.34±2.20
t或χ²		0.421	1.684	0.658

组别	n	T₂	T₃	T₄
C组	30	1（0，1）	1（1，1）	0（0，1）
L组	30	0（0，1）	1（0，1）	0（0，1）
Z		2.110^＊	1.970^＊	0.356

组别	n	T₂	T₃	T₄
C组	30	1（0，1）	1（1，1）	0（0，1）
L组	30	0（0，1）	1（0，1）	0（0，1）
Z		2.110^＊	1.970^＊	0.356

组别	n	T₀	T₁	T₅	ΔMAP
C组	30	98.5±8.8	87.4±9.2	100.4±10.9	12.5（6.2，18.1）
L组	30	101.0±11.8	88.9±12.4	99.0±15.4	6.3（2.6，17.4）
t或Z		0.925	0.526	0.420	1.538