在麻醉住院医师的纤维支气管镜插管培训中，使用短型无囊气管导管作为鼻咽通气道：一种有用的辅助手段。

Using a shortened uncuffed endotracheal tube as a nasopharyngeal airway: a useful adjunct during fiberoptic intubation training among anesthesia residents.

机构信息

Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Department of Anesthesia and Intensive Care, Faculty of Medicine, Menoufia University, Menoufia, Egypt.

出版信息

Afr Health Sci. 2023 Sep;23(3):576-583. doi: 10.4314/ahs.v23i3.67.

DOI:10.4314/ahs.v23i3.67

PMID:38357116

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10862577/

Abstract

BACKGROUND

Fiberoptic intubation (FOI) is considered a beneficial modality used to intubate life-threatening airway patients. This study aims at assessing the effectiveness of shortened uncuffed endotracheal tube as a nasopharyngeal airway during FOI.

METHODS

Between January 2019 and March 2021, this prospective randomized controlled trial has enrolled 62 adult patients (56 males and 6 females) with normal airways scheduled for elective oral FOI classified American Society of Anesthesiologists (ASA I-III), their age ranged 20-60 years. The patients were randomized into two equal groups (31 per each); in group I, FOI was carried using lingual traction, and in group II, FOI was carried out with lingual traction plus a shortened uncuffed endotracheal tube as a modified nasopharyngeal airway to maintain oxygenation. The time taken to successful tracheal intubation and other technical parameters have been measured. The heart rate (HR), mean arterial pressure (MAP), oxygen saturation (SpO), end-tidal carbon dioxide (EtCO), and any associated complications have been measured.

RESULTS

During insertion of the scope, the SpO2 was significantly decreased in group I (92.55 ± 7.94) compared to group II (97.42 ± 6.34), p=0.009. The heart rate, MAP, and EtCO were found to be insignificantly different in both groups (p>0.05). The time needed for intubation in group I (2.78±0.98 min) was prolonged compared with group II (1.95±1.02 min) p =0.002. The number of attempts was comparable in both groups, while the number of successful intubations from the 1st attempt was 12 (39%) compared to 18 (58%) in groups I and II respectively, p=0.36. The overall success rate by juniors was 71% in group I compared to 84% in group II, p=0.66 with a lower incidence of using rescue oxygen and other facilitating maneuvers.

CONCLUSIONS

The modified nasopharyngeal airway is a useful modality to facilitate oral FOI by anesthesia resident trainees.

摘要

背景

纤维光导插管（FOI）被认为是一种有益的方法，可用于插管危及生命的气道患者。本研究旨在评估缩短的无囊气管内导管作为 FOI 期间鼻咽气道的效果。

方法

本前瞻性随机对照试验于 2019 年 1 月至 2021 年 3 月期间纳入了 62 名拟行择期口腔 FOI 的成年患者（56 名男性和 6 名女性），其气道正常，美国麻醉医师协会（ASA）分级为 I-III 级，年龄在 20-60 岁之间。患者随机分为两组（每组 31 名）；在第 I 组中，使用舌牵引进行 FOI，在第 II 组中，使用舌牵引和缩短的无囊气管内导管作为改良的鼻咽气道来维持氧合。测量了成功气管插管所需的时间和其他技术参数。测量了心率（HR）、平均动脉压（MAP）、氧饱和度（SpO2）、呼气末二氧化碳（EtCO）和任何相关并发症。

结果

在插入镜时，与第 II 组（97.42 ± 6.34）相比，第 I 组（92.55 ± 7.94）的 SpO2 显著下降，p=0.009。两组的心率、MAP 和 EtCO 无显著差异（p>0.05）。第 I 组的插管时间（2.78±0.98 min）较第 II 组（1.95±1.02 min）延长，p=0.002。两组的尝试次数相当，而第 I 组第 1 次尝试成功插管的次数为 12 例（39%），第 II 组为 18 例（58%），p=0.36。初级医师的总体成功率在第 I 组为 71%，在第 II 组为 84%，p=0.66，使用氧气救援和其他辅助措施的发生率较低。