Application of superior laryngeal nerve block combined with intratracheal superficial anesthesia in tracheal intubation in elder-ly patients with hypertension
Objective To explore the application effects of superior laryngeal nerve block combined with intratracheal superficial anesthesia in tracheal intubation of elderly patients with hypertension,and further clarify the necessity of anesthesia regimen optimization for elderly patients with hypertension,so as to provide a new method for clinical anesthesia and improve the effect of surgical treatment.Methods 172 elderly hypertensive patients treated in Central Hospital of Suining City from March 2021 to March 2023 were selected as the observation subjects.They were divided into observation group and control group by simple randomization method,with 86 cases in each group.The control group received general anesthesia induced in-tubation,while the observation group received superior laryngeal nerve block combined with intratracheal superficial anesthesia.The intubation results(one-time success rate of tracheal intubation,total success rate of intubation,average intubation time,in-cidence of choking cough)of the two groups were compared.The changes of hemodynamic indexes[heart rate(HR),blood pressure(SBP,DBP)and saturation of percutaneous oxygen(SpO2)]before,during and after intubation(T1,T2,T3)in the two groups were compared.The levels of serum adrenaline(E),norepinephrine(NE),and cortisol(Cor)before intubation(T1)and after successful intubation(T3)in the two groups were compared.The occurrence of adverse events during intubation was recorded in both groups.The recovery status of patients was recorded after the end of surgery.Results The success rate of one-time intubation in the observation group(97.67％)was higher than that in the control group(89.53％),and the average intubation time[(34.52±5.19)s]was shorter than that in the control group[(40.76±5.49)s](allP＜0.05).There was no significant difference in the total success rate of intubation and the incidence of choking cough between the two groups(P＞0.05).At T2 and T3,the HR,SBP and DBP of the observation group were lower than those of the control group,while the SpO2 was higher than that of control group(all P＜0.05).At T3,the levels of E and NE of the observation group[(35.58±6.26)kg/m2,(158.76±14.36)g/L]were lower than those of the control group[(47.30±9.22)kg/m2,(167.74±14.46)g/L](all P＜0.05).The recovery time of muscle relaxation,extubation time and PAED score of the observation group[(8.16±2.35)min,(10.56±3.30)min,(8.67±1.32)points]were shorter or lower than those of the control group[(9.79±3.05)min,(12.67±3.20)min,(10.40±1.38)points](P＜0.05).Conclusion The combination of superior laryngeal nerve block and intratracheal superficial anesthesia can significantly reduce intubation response in elderly pa-tients with hypertension,which is beneficial to maintaining hemodynamic stability of patients,and has certain clinical applica-tion value.
elderlyhypertensionsuperior laryngeal nerve blockintratracheal superficial anesthesiasuccess rate of intubationhemodynamics
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