关键词: 光棒, 经鼻盲探插管, 经鼻气管内插管, 困难气道, 平均动脉压, 心率

Abstract: Objective To evaluate the effectiveness of nasotracheal intubation using lightwand in patients with difficult airways in oral and maxillofacial surger
y,and to provide a new method for difficult airway management.Methods 76 ASAⅠor Ⅱ grade patients with difficult airways who required nasotracheal intubation were randomly divided into using lightwand group (lightwand group) (n=38) and blind intubation group (n=38).The intubation procedure was guided by the light spot at neck in lightwand group while in blind intubation group it was guided by the patients’ breathing sound.The intubation success rate,intubation time,changes of  mean arterial pressure(MAP) and heart rate(HR) and postoperative complications of the patients were compared between two groups.Results In lightwand group, the intubation success rate (89.5%,34/38) was obviously higher than blind intubation group (71.1%,27/38)(P<0.05);the intubation time ［(89.9±26.8) s］ was significantly lower than  blind intubation group ［(134.9±32.8) s］ (P<0.001);
the postoperative incidence rate of  pharyngalgia (14.7%,5/34)  was significantly lower than blind intubation group (40.7%,11/27) (P<
0.05);there were no significant differences of the incidence rates of hoarseness and epistaxis between two groups(P>0.05);the   MAP values of patients  were lower than blind intubation group during intubation period and 1 min after intubation,and there were no significant differences of HR  of patients at different time points between two groups(P>0.05).Conclusion To the  patients with difficult airways,the nasotracheal intubation using lightwand is superior to blind intubation with higher success rate,more stable haemodynamic responses,and less postoperative complications.The technique could be used as a simple and practical approach for nasotracheal intubation in difficult airways.

Key words: lightwand, blind nasal intubation, nasotracheal intubation, difficult airways, mean anterial pressure, heart rate