Department of Anesthesiology, Institute and Hospital of Stomatology, Nanjing University Medical School, Nanjing 210008, PR China.
Int J Oral Maxillofac Surg. 2013 Sep;42(9):1049-53. doi: 10.1016/j.ijom.2013.01.027. Epub 2013 May 25.
In oromaxillofacial surgery patients, the incidence of difficult airways is up to 15.4-16.9%. Blind nasal intubation remains a safe technique for difficult airway management in some remote areas where a fibreoptic bronchoscope is not always available. The lightwand is an easy-to-use, highly economical device, and can facilitate endotracheal intubation through illumination in the neck. The study aims to evaluate the efficacy of nasotracheal intubation using lightwand in oromaxillofacial surgery patients with difficult airways. One hundred and sixteen patients with difficult airways requiring nasotracheal intubation were randomly divided into a lightwand group and a blind group, with 58 cases in each group. The first attempt and overall success rates of lightwand intubation were 84.5% and 93.1%, respectively, which were higher than those of blind intubation (65.5% and 75.9%, respectively; P<0.05). The total intubation time was 91.4±27.7s in the lightwand group and 130.7±33.4s in the blind group (P<0.001). Patients in the lightwand group also experienced more stable haemodynamic responses and less pharyngalgia. In conclusion, lightwand-guided nasotracheal intubation is superior to blind intubation in patients with difficult airways, with a higher success rate, more stable haemodynamic responses, and fewer postoperative complications.
在口腔颌面外科手术患者中，困难气道的发生率高达 15.4-16.9%。在某些偏远地区，纤维支气管镜并非随时可用，盲目鼻插管仍然是困难气道管理的安全技术。光棒是一种易于使用、经济高效的设备，可以通过照亮颈部来促进气管内插管。本研究旨在评估光棒引导经鼻插管在口腔颌面外科手术困难气道患者中的疗效。116 例需要经鼻插管的困难气道患者随机分为光棒组和盲探组，每组 58 例。光棒组首次尝试和总成功率分别为 84.5%和 93.1%，高于盲探组（分别为 65.5%和 75.9%；P<0.05）。光棒组的总插管时间为 91.4±27.7s，盲探组为 130.7±33.4s（P<0.001）。光棒组患者的血流动力学反应更稳定，咽痛发生率更低。总之，光棒引导经鼻插管在困难气道患者中优于盲目插管，具有更高的成功率、更稳定的血流动力学反应和更少的术后并发症。
