Ultrasonography-guided Block Of The Internal Superior Laryngeal Nerve Of The Patients In ICU Undergoing Mechanical Ventilation Through Orotracheal Intubation

Objective:Mechanical ventilation is an important measure for ICU to treat critically ill patients.Nerve block therapy has effective analgesia and less adverse reactions.This academic dissertation explores the effect of ultrasonography-guided block of internal superior laryngeal nerve on analgesic,the comfort and the dosage of systemic intravenous analgesics of patients in the ICU undergoing mechanical ventilation through orotracheal intubation,and evaluates the safety of ultrasound-guided nerve block analgesia in ICU mechanical ventilation.Methods:A total of sixty patients who were treated with Mechanical Ventilation through orotracheal intubation in our ICU from November2018 to December 2019 were divided into group A?Observation Group?and group B?Control Group?according to SPSS random number group method,30 cases in each group.Analgesia drugs and sedative drugs intravenously was fixed,when the patients in the group reached the ideal setting state of analgesia and sedation,at this time,they were recorded as T0,patients in the group A were treated with ultrasonography-guided block of bilateral internal branch of superior laryngeal nerve,patients in the group B were not treated with nerve block,30 minutes,2 hours,4hours and 6 hours after the completion of the block were recorded as T1,T2,T3 and T4,respectively.Record the blood pressure?BP?,heart rate?HR?and saturation of pulse oximetry?Sp O₂?at each time point.Endotracheal tube tolerance rating,CPOT score and RASS score were monitored at each time point.The Total dosages of analgesia drugs and sedative drugs in 6 hours intravenously and the incidence of adverse reactions were recorded.Results:The CPOT scores of group A at the points of T2 and T4 are lower than the same points of group B,and at the time points of T1,T2,T3 and T4 in group A were all lower than that at the time points of T0?P<0.05?.The RASS score of group A was lower than that of group B at each time point?P<0.05?.At the time points of T2 and T4,the number of patients in group A with tolerance level of 1 and 2 was higher than that in group B,and the number of patients with tolerance level of 3 was lower than that in group B?P<0.05?.Moreover,the tolerance level of T2,T3and T4 in group A was superior to the time point of T0?P<0.05?.Compared with group B,MAP of group A was higher?P<0.05?,there was no significant difference in HR and Sp O₂between the two groups at each time point?P>0.05?.There was no significant difference in MAP,HR and Sp O₂at each time point before and after block in group A.The dosage of sufentanil and midazolam in group A was lower than that in group B?P<0.05?within 6 hours.No adverse reactions such as nerve and blood vessel damage occurred in the group A.There was no statistical different in the general condition between two groups.Conclusions:1.Ultrasonography-guided block of internal superior laryngeal nerve has definite effect of analgesic,and it can effectively improve the level of the comfort of patients in ICU undergoing Mechanical ventilate through orotracheal intubation.2.Compared to solely using systemic analgesics and sedatives intravenously,ultrasonography-guided block of internal superior laryngeal nerve can reduce the dosage of systemic intravenous analgesics and sedatives of the patients in ICU undergoing Mechanical ventilate through orotracheal intubation.3.Ultrasonography-guided block of internal superior laryngeal nerve can maintain hemodynamics steadily of the patients in ICU undergoing Mechanical ventilate through orotracheal intubation,and less adverse reactions were observed.