Department of Anaesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Eur J Anaesthesiol. 2010 May;27(5):461-7. doi: 10.1097/EJA.0b013e328332845a.
The blind intubation device (BID) was introduced for awake nasotracheal intubation recently. The aim of this study was to compare the cardiovascular responses and associated airway complications of fibreoptic bronchoscope (FOB) with those of BID. The intubation attempts and intubation time were also compared.
Forty-one ASA grade I or II normotensive adult patients with difficult airways, requiring nasotracheal intubation for elective oral and maxillofacial or plastic surgery, were randomly assigned to intubation with either FOB (n = 21) or BID (n = 20). The cardiovascular values were invasively measured at specific time points. Postoperative airway complications were assessed using a questionnaire.
Nasotracheal intubation was successful in both groups (100%). After sedation, blood pressure (BP) decreased significantly compared with baseline values in both groups (P < 0.05). Compared with baseline or postsedation values, both devices led to significant increases in BP when we inserted the endotracheal tube or the oesophagus airway through the nasal cavity (P < 0.05), while heart rate did not change significantly. Passing the FOB or light-guided catheter through the vocal cord and advancing the endotracheal tube into the trachea caused significant increases in both BP and heart rate compared with baseline or postsedation values (P < 0.05). No significant difference in BP or heart rate between the two groups was found. The intubation time was similar (P = 0.13). Blood detected on the intubation devices was similar in both groups (P = 0.73). Nasal pain, sore throat and hoarseness observed after 24 h was also similar (P = 0.49, 0.36, 0.51, respectively).
Both FOB and BID caused similarly slight cardiovascular responses during awake nasotracheal intubation in normotensive adults. The intubation-associated airway complications were similar.
盲探气管插管装置（BID）最近被引入用于清醒经鼻插管。本研究旨在比较纤维支气管镜（FOB）与 BID 引起的心血管反应和相关气道并发症。同时比较插管尝试次数和插管时间。
41 例 ASA 分级 I 或 II 级血压正常的成年患者，因择期口腔颌面或整形手术需要经鼻气管插管，随机分为 FOB 组（n = 21）或 BID 组（n = 20）进行插管。在特定时间点进行有创心血管值测量。术后气道并发症采用问卷进行评估。
两组均成功完成经鼻插管（100%）。镇静后，两组的血压（BP）均较基础值显著降低（P < 0.05）。与基础值或镇静后值相比，当我们将气管内导管或食管气道通过鼻腔插入时，两种器械均导致 BP 显著升高（P < 0.05），而心率无明显变化。当 FOB 或光导导管通过声带并将气管内导管推进气管时，BP 和心率均较基础值或镇静后值显著升高（P < 0.05）。两组之间的 BP 或心率无显著差异。插管时间相似（P = 0.13）。两组插管器械上检测到的血液量相似（P = 0.73）。24 小时后观察到的鼻痛、咽痛和声音嘶哑也相似（P = 0.49、0.36、0.51）。
在血压正常的成年患者清醒经鼻插管期间，FOB 和 BID 引起的心血管反应相似。与插管相关的气道并发症相似。
