ĐÁNH GIÁ TÍNH KHẢ THI CỦA ĐẶT NỘI KHÍ QUẢN QUA ỐNG NỘI SOI MỀM CÓ AN THẦN TỈNH VÀ OXY HÓA TRƯỚC BẰNG OXY LƯU LƯỢNG CAO Ở NGƯỜI BỆNH ÁP XE VÙNG HÀM MẶT

Abstract

Objectives: Assessment of the feasibility of fiberoptic nasotracheal intubation with conscious sedation with target-controlled propofol infusion (TCI - propofol) and preoxygenation using high flow nasal oxygen (HFNO) in patients undergoing maxillofacial abscess. Materials and methods: Prospective and randomized controlled clinical trial study on 64 patients undergoing surgery maxillofacial abscess with trismus and upper airway injury, from 11/2023 to 10/2024 at National Hospital of Odonto-Stomatology, Hanoi. Comparison of 2 groups fiberoptic nasotracheal intubation with  preoxygenation: Group 1 (n = 32) preoxygenation using HFNO, conscious sedation with TCI - propofol and surface anesthesia of the upper airway; Group 2 (n = 32) preoxygenation with low flow nasal oxygen (LFNO) and surface anesthesia of the upper airway. Main criteria: Grading of intubation conditions (very good, good, fair, poor), intubation time and SpO2 index immediately after intubation. Results: Group 1 had good and very good intubation conditions (90.7%) were higher (p<0.05), duration of intubation (98.50±15.96 seconds) was shorter (p<0.05) than group 2 (65.6% and 114.09±20.64 seconds); SpO2 index immediately after intubation below 95% occurred in 6.25% of patients in Group 2, but was not observed in Group 1. Conclusion: Preoxygenation using HFNO combined with conscious sedation using TCI - propofol helped to successful fiberoptic nasotracheal intubation without without desaturation below 95% in patients undergoing maxillofacial abscess surgery with trismus and upper airway injury.