To compare the difference in endotracheal intubation in participants with difficult airway between under general anesthesia by Transnasal Humidified Rapid-Insufflation Ventilatory Exchange and under traditional sedation by mask ventilation. The investigators focus on the different outcomes in oxygenation maintaince, carbon dioxide removal and the effectiveness of safety apnea time, to evaluate the safety of receiving endotracheal intubation under general anesthesia in participants with difficult airway.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
42
The nasal cavity was disinfected with Iodophor cotton swab, and the appropriate nasal cavity was selected for endotracheal intubation assisted by fiberoptic bronchoscope according to the experience of anesthesiologists. After the endotracheal intubation was fixed, the anesthesia machine was connected for mechanical ventilation. The anesthesia machine was set at 50% oxygen +50% air, and the tidal volume was set at 6-8ml/kg.
The Control Group will receive sequential intravenous infusion of Sufentanil 5ug, midazolam 0.05mg/kg, and propofol 1-2ug/ml, to make the BIS between 70 and 80. 2ml tetracaine was injected with cyclothyroid membrane puncture, and the nasal cavity was disinfected with iodophor cotton swab. According to the experience of anesthesiologists, the appropriate nasal cavity was selected for intranasal endotracheal intubation assisted by fiberbronchoscope. After the endotracheal intubation was successful, the anesthesia machine was connected for mechanical ventilation, full narcotic inducer will be injected. The anesthesia machine was set at 50% oxygen +50% air, and the tidal volume was set at 6-8ml/kg.
Peking University Hospital of Stomatology
Beijing, Beijing Municipality, China
RECRUITINGBlood oxygen pressure
Blood oxygen pressure after intubation immediately.
Time frame: Day 0
Pulse oxygen saturation
Pulse oxygen saturation after intubation immediately.
Time frame: Day 0
Blood carbon dioxide pressure
Blood carbon dioxide pressure after intubation immediately.
Time frame: Day 0
Endtidal CO2
Endtidal CO2 at time point of TA、TB、TC、TD
Time frame: Day 0
Success of intubation
Proportion of successful endotracheal intubation
Time frame: Day 0
Arrhythmias or dramatic haemodynamic fluctuations
Arrhythmias and dramatic fluctuations in heart rate and blood pressure: types and times of arrhythmias in the test were recorded. Changes in heart rate and blood pressure more than 30% before surgery were recorded as dramatic fluctuations.
Time frame: Day 0
Tolerance of intubation
The score of patient's tolerance to endotracheal intubation one day after surgery (0-10 points, 0 point is completely intolerable, 10 point is completely intolerable)
Time frame: Day 1
Time to complete intubation
Time required to complete endotracheal intubation
Time frame: Day 0
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Midazolam 0.05mg/kg, intravenous injection
Sufentanil 0.02-0.05ug/kg, intravenous injection
Propofol 2-3ug/ml, intravenous injection
Rocuronium 0.06mg/kg, intravenous injection
Make BIS \< 60 .
Sufentanil 5ug, intravenous injection
Midazolam 0.05mg/kg, intravenous injection
Propofol 1-2ug/ml, intravenous injection
2ml tetracaine was injected with cyclothyroid membrane puncture.
Make the BIS between 70 and 80.
SPO2 below 95%
Percentage of patients with pulse oxygen saturation below 95% during the trial
Time frame: Day 0
SPO2 below 92%
Percentage of patients with pulse oxygen saturation below 92% during the trial
Time frame: Day 0