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经鼻气管插管时使用预成型鼻气管导管的鼻腔引导方法效果比较:一项前瞻性随机对照试验。

Comparison of the Nasal Cavity Guidance Methods' Effects during Nasotracheal Intubation Using a Preformed Nasotracheal Tube: A Prospective Randomized Controlled Trial.

机构信息

Department of Anesthesiology and Pain Medicine, Chonnam National University Hospital, Gwangju 61469, Republic of Korea.

Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Hwasun 58128, Republic of Korea.

出版信息

Int J Environ Res Public Health. 2023 Mar 3;20(5):4503. doi: 10.3390/ijerph20054503.

Abstract

Nasotracheal intubation is mainly performed to provide a safe airway during maxillofacial surgeries. Several guiding devices are suggested to facilitate nasotracheal intubation and reduce complications. We attempted to compare intubation conditions during nasotracheal intubation using a nasogastric tube and a suction catheter, which are readily available in operating rooms. In this study, 114 patients undergoing maxillofacial surgery were randomly divided into the nasogastric tube guidance group (NG group) and the suction catheter guidance group (SC group). The primary outcome was the total intubation time. Moreover, the incidence and degree of epistaxis, the position of the tube in the nasal cavity after intubation, and the number of manipulations during intubation in the nasal cavity were investigated. The insertion time from the nostril to the oral cavity and the total intubation time were significantly shorter in the SC group than in the NG group ( < 0.001). The incidence of epistaxis was lower at 35.1% in the NG group and 43.9% in the SC group than the previously reported 60-80%, but there was no statistical difference between the two groups. The use of a suction catheter aid during nasotracheal intubation can be used effectively because it shortens the intubation time and does not increase complications.

摘要

经鼻气管插管主要用于在颌面外科手术中提供安全的气道。有几种引导装置被建议用于方便经鼻气管插管并减少并发症。我们试图比较使用手术室中常用的鼻胃管和吸引导管进行经鼻气管插管的插管条件。在这项研究中,114 名接受颌面外科手术的患者被随机分为鼻胃管引导组(NG 组)和吸引导管引导组(SC 组)。主要结局是总插管时间。此外,还研究了鼻出血的发生率和程度、插管后鼻腔内导管的位置以及插管过程中的操作次数。SC 组从鼻孔到口腔的插入时间和总插管时间明显短于 NG 组(<0.001)。NG 组的鼻出血发生率为 35.1%,SC 组为 43.9%,低于之前报道的 60-80%,但两组之间无统计学差异。在经鼻气管插管中使用吸引导管辅助可以有效地缩短插管时间,并且不会增加并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dafb/10002088/82e26d6177b6/ijerph-20-04503-g001.jpg

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