Ali Shahna, Athar Manazir, Ahmed Syed Moied, Siddiqi Obaid Ahmad, Badar Amrin
Department of Anaesthesiology and Critical Care, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
Ann Maxillofac Surg. 2017 Jul-Dec;7(2):202-206. doi: 10.4103/ams.ams_10_17.
This study was designed to evaluate the efficacy of awake oral to submental conversion over asleep technique.
This randomized clinical study was conducted in maxillofacial department of a tertiary care hospital in patients who had panfacial or mandibular fractures requiring elective surgical correction. The patients were randomly divided into two groups of 12 patients each, asleep fiberoptic-assisted submental intubation (SMI) (Group G; = 12) and awake fiberoptic-assisted SMI (Group A; = 12). The primary predictor was mean conversion time of oral to SMI while other predictors were overall success rate, ease of conversion, and complications. Data are presented as mean (±standard deviation) and frequencies (%) as appropriate. Statistical analysis done using unpaired -test or Chi-square test was performed and < 0.05 was considered statistically significant.
Twenty-four patients (19:5;Male:Female) aged 18-55 years (Group G = 35.96; Group A = 32.43 years) were included in the study. SMI was successful in all except two patients in group G. Overall success rate was similar in both groups. Time to convert orotracheal intubation to SMI was significantly less in group A (Group G = 9.55 ± 1.42, Group A = 5.67 ± 1.73; < 0.001). Ease of SMI was found Grade I in 30% and 83% of the patients of group G and A, respectively. No serious complications were observed except 2 cases of bleeding, and 1 case of tube damage.
Awake oral to submental conversion requires lesser time in comparison to asleep technique besides improving the ease (Δ = 53%) of the procedure.
本研究旨在评估清醒状态下经口转为颏下插管技术相对于睡眠状态下该技术的疗效。
本随机临床研究在一家三级护理医院的颌面外科进行，研究对象为需要择期手术矫正的全面部或下颌骨骨折患者。患者被随机分为两组，每组12例，分别接受睡眠状态下纤维支气管镜辅助颏下插管（SMI）（G组；n = 12）和清醒状态下纤维支气管镜辅助SMI（A组；n = 12）。主要预测指标为经口转为SMI的平均转换时间，其他预测指标为总体成功率、转换的难易程度及并发症。数据以均值（±标准差）和适当的频率（%）表示。采用不成对t检验或卡方检验进行统计分析，P < 0.05被认为具有统计学意义。
本研究纳入了24例年龄在18 - 55岁的患者（19例男性：5例女性；G组平均年龄 = 35.96岁；A组平均年龄 = 32.43岁）。G组除2例患者外，SMI均成功。两组总体成功率相似。A组经口气管插管转为SMI的时间显著短于G组（G组 = 9.55 ± 1.42，A组 = 5.67 ± 1.73；P < 0.001）。G组和A组分别有30%和83%的患者的SMI操作难度为I级。除2例出血和1例导管损伤外，未观察到严重并发症。
与睡眠状态下的技术相比，清醒状态下经口转为颏下插管所需时间更短，且操作更容易（提高了53%）。
