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Abstract：
BACKGROUND: Different approach ultrasound-guided superior laryngeal nerve block was used to aid awake intubation, but little is known which approach was superior. We aimed to compare the parasagittal and transverse approaches for ultrasound-guided superior laryngeal nerve block in adult patients undergoing awake intubation.
METHODS: Fifty patients with awake orotracheal intubation were randomized to receive either a parasagittal or transverse ultrasound-guided superior laryngeal nerve block. The primary outcome was patient\'s quality of airway anesthesia grade during insertion of the tube into the trachea. The patients\' tube tolerance score after intubation, total procedure time, mean arterial pressure, heart rate, Ramsay sedation score at each time point, incidence of sore throat both 1 h and 24 h after extubation, and hoarseness before intubation, 1 h and 24 h after extubation were documented.
RESULTS: Patients\' quality of airway anesthesia was significantly better in the parasagittal group than in the transverse group (median grade[IQR], 0 [0-1] vs. 1 [0-1], P = 0.036). Patients in the parasagittal approach group had better tube tolerance scores (median score [IQR],1[1-1] vs. 1 [1-1.5], P = 0.042) and shorter total procedure time (median time [IQR], 113 s [98.5-125.5] vs. 188 s [149.5-260], P < 0.001) than those in the transverse approach group. The incidence of sore throat 24 h after extubation was lower in the parasagittal group (8% vs. 36%, P = 0.041). Hoarseness occurred in more than half of the patients in parasagittal group before intubation (72% vs. 40%, P = 0.023).
CONCLUSIONS: Compared to the transverse approach, the ultrasound-guided parasagittal approach showed improved efficacy in terms of the quality of airway topical anesthesia and shorter total procedure time for superior laryngeal nerve block.
BACKGROUND: This prospective, randomized controlled trial was approved by the Ethics Committee of Nanjing First Hospital (KY20220425-014) and registered in the Chinese Clinical Trial Registry (19/6/2022, ChiCTR2200061287) prior to patient enrollment. Written informed consent was obtained from all participants in this trial.
METHODS: Fifty patients with awake orotracheal intubation were randomized to receive either a parasagittal or transverse ultrasound-guided superior laryngeal nerve block. The primary outcome was patient\'s quality of airway anesthesia grade during insertion of the tube into the trachea. The patients\' tube tolerance score after intubation, total procedure time, mean arterial pressure, heart rate, Ramsay sedation score at each time point, incidence of sore throat both 1 h and 24 h after extubation, and hoarseness before intubation, 1 h and 24 h after extubation were documented.
RESULTS: Patients\' quality of airway anesthesia was significantly better in the parasagittal group than in the transverse group (median grade[IQR], 0 [0-1] vs. 1 [0-1], P = 0.036). Patients in the parasagittal approach group had better tube tolerance scores (median score [IQR],1[1-1] vs. 1 [1-1.5], P = 0.042) and shorter total procedure time (median time [IQR], 113 s [98.5-125.5] vs. 188 s [149.5-260], P < 0.001) than those in the transverse approach group. The incidence of sore throat 24 h after extubation was lower in the parasagittal group (8% vs. 36%, P = 0.041). Hoarseness occurred in more than half of the patients in parasagittal group before intubation (72% vs. 40%, P = 0.023).
CONCLUSIONS: Compared to the transverse approach, the ultrasound-guided parasagittal approach showed improved efficacy in terms of the quality of airway topical anesthesia and shorter total procedure time for superior laryngeal nerve block.
BACKGROUND: This prospective, randomized controlled trial was approved by the Ethics Committee of Nanjing First Hospital (KY20220425-014) and registered in the Chinese Clinical Trial Registry (19/6/2022, ChiCTR2200061287) prior to patient enrollment. Written informed consent was obtained from all participants in this trial.
摘要：
背景：不同方法超声引导喉上神经阻滞用于辅助清醒插管，但鲜为人知的是，哪种方法更优越。我们旨在比较成年患者清醒插管时超声引导下喉上神经阻滞的矢状和横向入路。
方法：50例清醒经口气管插管患者随机接受矢状旁及横行超声引导喉上神经阻滞。主要结果是患者气管插管期间的气道麻醉质量等级。插管后的患者管耐受性评分，总手术时间,平均动脉压,心率,每个时间点的Ramsay镇静评分,拔管后1小时和24小时喉咙痛的发生率，插管前声音嘶哑，记录拔管后1小时和24小时。
结果：矢状旁组患者的气道麻醉质量明显优于横行组（中位级别[IQR]，0[0-1]vs.1[0-1],P=0.036)。矢状旁入路组患者的管耐受性评分较好（中位数评分[IQR]，1[1-1]vs.1[1-1.5],P=0.042)和较短的总手术时间(中位时间[IQR]，113s[98.5-125.5]vs.188s[149.5-260]，P<0.001）比横向入路组的那些。矢状旁组拔管后24h咽喉痛的发生率较低(8%vs.36%,P=0.041)。在插管前，矢状旁组超过一半的患者出现声音嘶哑(72%vs.40%,P=0.023)。
结论：与横向入路相比，超声引导下矢状旁入路在气道局部麻醉质量和喉上神经阻滞的总手术时间方面均有改善.
背景：这种前瞻性，随机对照试验获得南京市第一医院伦理委员会批准(KY20220425-014),并在患者入组前在中国临床试验注册中心(2022年6月19日,ChiCTR2200061287)注册.从该试验的所有参与者获得书面知情同意书。
方法：50例清醒经口气管插管患者随机接受矢状旁及横行超声引导喉上神经阻滞。主要结果是患者气管插管期间的气道麻醉质量等级。插管后的患者管耐受性评分，总手术时间,平均动脉压,心率,每个时间点的Ramsay镇静评分,拔管后1小时和24小时喉咙痛的发生率，插管前声音嘶哑，记录拔管后1小时和24小时。
结果：矢状旁组患者的气道麻醉质量明显优于横行组（中位级别[IQR]，0[0-1]vs.1[0-1],P=0.036)。矢状旁入路组患者的管耐受性评分较好（中位数评分[IQR]，1[1-1]vs.1[1-1.5],P=0.042)和较短的总手术时间(中位时间[IQR]，113s[98.5-125.5]vs.188s[149.5-260]，P<0.001）比横向入路组的那些。矢状旁组拔管后24h咽喉痛的发生率较低(8%vs.36%,P=0.041)。在插管前，矢状旁组超过一半的患者出现声音嘶哑(72%vs.40%,P=0.023)。
结论：与横向入路相比，超声引导下矢状旁入路在气道局部麻醉质量和喉上神经阻滞的总手术时间方面均有改善.
背景：这种前瞻性，随机对照试验获得南京市第一医院伦理委员会批准(KY20220425-014),并在患者入组前在中国临床试验注册中心(2022年6月19日,ChiCTR2200061287)注册.从该试验的所有参与者获得书面知情同意书。
