Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China.
BMC Anesthesiol. 2022 Jul 2;22(1):203. doi: 10.1186/s12871-022-01749-8.
Spray-as-you-go (SAYGo) airway topical anesthesia and nerve block are common techniques used during awake tracheal intubation. However, their effects have not been described during double-lumen tube intubation. We report on a prospective randomized study that aimed to compare the intubation effects of SAYGo and nerve block patients undergoing thoracic surgery.
Sixty-six American Society of Anesthesiologists (ASA) physical status I and II patients were scheduled to undergo double-lumen tube (DLT) tracheal intubation for thoracic surgery. The patients were randomly assigned into control (Group C), ultrasound (Group U), and flexible intubation scope (Group F) groups with 22 cases in each group. Patients in Group C were induced with a standard anesthetic regimen. Patients in Groups U and F were treated with superior laryngeal nerve (SLN) block combined with transtracheal injection (TTI) and given a SAYGo airway topical anesthesia before intubation. Hemodynamic variables during intubation process were recorded as the primary outcome. Additional patient data were recorded including the occurrence of adverse events, the level of hoarseness, the occurrence of sore throats, memory function and the level of patient satisfaction with anesthesia.
The blood pressure (BP) and heart rate (HR) of patients in group C was significantly increased 1 min after tracheal intubation (P < 0.05) compared to before anesthesia. The BP and HR of patients in Groups U and F remained stable. 10 cases of hypertension were observed in Group C, 6 cases in Group U and 1 case in Group F. In Group C, tachycardia was observed in 9 patients along with 9 cases in Group U and 4 cases in Group F. In Group U, 4 patients experienced puncture and bleeding were and 8 patients had a poor memory of TTI. No significant differences were found in the incidence of hoarseness, sore throats, and satisfaction with anesthesia in postoperative follow-up.
SAYGo airway topical anesthesia and SLN block combined with the TTI technique can inhibit the cardiovascular response during DLT tracheal intubation. The SAYGo technique has fewer complications and more advantages compared to other approaches.
喷雾即走（SAYGo）气道局部麻醉和神经阻滞是清醒气管插管中常用的技术。然而，它们在双腔管插管中的效果尚未描述。我们报告了一项前瞻性随机研究，旨在比较在接受胸科手术的患者中，SAYGo 和神经阻滞的插管效果。
66 名美国麻醉医师学会（ASA）身体状况 I 和 II 级的患者计划接受双腔管（DLT）气管插管进行胸科手术。患者被随机分为对照组（C 组）、超声组（U 组）和柔性插管镜组（F 组），每组 22 例。C 组患者采用标准麻醉方案诱导。U 组和 F 组患者采用喉上神经（SLN）阻滞联合经气管注射（TTI），并在插管前进行 SAYGo 气道局部麻醉。记录插管过程中的血流动力学变量作为主要结果。记录其他患者数据，包括不良事件的发生、声音嘶哑程度、咽喉痛的发生、记忆功能以及患者对麻醉的满意度。
与麻醉前相比，C 组患者的血压（BP）和心率（HR）在气管插管后 1 分钟显著升高（P < 0.05）。U 组和 F 组患者的 BP 和 HR 保持稳定。C 组有 10 例高血压，U 组 6 例，F 组 1 例。C 组有 9 例心动过速，U 组有 9 例，F 组有 4 例。U 组有 4 例患者出现穿刺和出血，8 例患者 TTI 记忆较差。在术后随访中，声音嘶哑、咽喉痛和对麻醉的满意度方面，各组间无显著差异。
SAYGo 气道局部麻醉和 SLN 阻滞联合 TTI 技术可抑制 DLT 气管插管期间的心血管反应。与其他方法相比，SAYGo 技术并发症更少，优势更多。
