The application of the ultrasonic atomization surface anesthesia with lidocaine for an awake endotracheal intubation during autonomous position-display

Abstract

Objective To explore the feasibility of the ultrasonic atomization surface anesthesia with lidocaine for awake fiberoptic endotracheal intubation in patients' autonomous position-display before general anesthesia and to evaluate its advantages. Methods 68 adult patients who needed prone position for elective surgery under general anesthesia were selected and randomly divided into two groups, the control group and the treatment group, each group in 34 cases.In control group patients were received surface anesthesia of cricothyroid membrane puncture.In treatment group, nebulized 2% lidocaine with ultrasonic nebulizer was used for topical anesthesia.Patients lied in the prone position according to their own comfort with the guide of the medical staff in the waking state after an awake fiberoptic endotracheal intubation.The statistics of mean arterial pressure (MAP) and heart rate (HR) were recorded respectively in the basal state(T0), in the time instantly after intubations(T1), in the 3 minute after intubations(T2) and in the time instantly after the body turning(T3). Choking cough response were recorded during endotracheal intubation.Patients were asked the efficacy of surface anesthesia and the tolerance for awake intubation after operation. Results Patients in both two groups completed the whole process smoothly.MAP and HR had no significant differences between the two groups in the same time point (all P>0.05). There were no statistical significance between the two groups in choking cough response, the time of surface anesthesia and intubation, neither (all P>0.05). Conclusion The surface anesthesia with lidocaine by continuous ultrasonic atomizing inhalation is a good and simple method deserving generalization with plenty merits and is practicable for patients to display position autonomously.This method have the advantages of small operation, it will and can replace cricothyroid membrane puncture. Key words: Lidocaine; Ultrasonic atomization; Cricothyroid membrane puncture; Awake endotracheal intubation; Posture