Ma Yuanyuan, Cao Xue, Zhang Hong, Ge Shengjin
Department of Anesthesia, Zhongshan Hospital, Fudan University, Shanghai, China.
J Int Med Res. 2021 Jan;49(1):300060520987395. doi: 10.1177/0300060520987395.
To assess the feasibility of an awake fiberoptic intubation (AFOI) protocol.
We enrolled 40 patients with simulated difficult intubation. The protocol consisted of conscious sedation (midazolam, 0.03 mg/kg and sufentanil, 0.1 µg/kg), regional anesthesia, and intubation. The time, first-attempt intubation success rate, hemodynamic parameters, blood oxygen saturation (SpO), intubation amnesia rate, patient satisfaction, and relative complications were recorded.
AFOI was completed in all patients. The average total AFOI time was 14.17 ± 1.47 minutes, and the time to placing the landmark-guided bilateral superior laryngeal nerve block was 1.24 ± 0.42 minutes. The first-attempt intubation success rate was 97.5%, and patient satisfaction was 90%. Blood pressure changed (<20%) briefly after administering conscious sedation. Heart rates did not change significantly, and SpO remained stable and ≥95%. Three patients had a sore throat, which resolved on postoperative day 1 without other complications. On postoperative day 1, 82.5% (33/40) of the patients had no recall of AFOI, and 17.5% (7/40) had only an indistinct memory.
The protocol was feasible with a high first-attempt intubation success rate and low complications rate. Hemodynamic parameters and respiration remained stable, with high patient satisfaction and effective amnesia.
评估清醒纤支镜引导插管（AFOI）方案的可行性。
我们纳入了40例模拟困难插管患者。该方案包括清醒镇静（咪达唑仑，0.03mg/kg和舒芬太尼，0.1μg/kg）、区域麻醉和插管。记录时间、首次插管成功率、血流动力学参数、血氧饱和度（SpO）、插管遗忘率、患者满意度和相关并发症。
所有患者均完成了AFOI。AFOI的平均总时间为14.17±1.47分钟，放置标志性引导双侧喉上神经阻滞的时间为1.24±0.42分钟。首次插管成功率为97.5%，患者满意度为90%。给予清醒镇静后血压短暂变化（<20%）。心率无明显变化，SpO保持稳定且≥95%。3例患者出现咽痛，术后第1天缓解，无其他并发症。术后第1天，82.5%（33/40）的患者对AFOI无记忆，17.5%（7/40）仅有模糊记忆。
该方案可行，首次插管成功率高，并发症发生率低。血流动力学参数和呼吸保持稳定，患者满意度高，遗忘效果良好。
