Effect of application fiberoptic bronchoscope on the stress reaction caused by nasotracheal intubation in patients with obstructive sleep apnea syndrome

Objective To investigate the effects of nasotracheal intubation assisted by fiberoptic bronchoscope on the stress reaction in patients with obstructive sleep apnea syndrome(OSAS).Methods Sixty ASA Ⅱ or Ⅲ, Mallampati Ⅲ or Ⅳpatients, with OSAS,aged 41-65 years,scheduled for uvulopalatopharyngoplasty, were randomly divided into 2 groups (n=30 each):group A, blind nasotracheal intubation and group B, nasotracheal intubation assisted FOB. MAP,HR,SpO2 and change situation of ECG were recorded at before induction(T0),immediately after the intubation(T1),and1(T2),3 min(T3) after intubation; and the blood sample were obtained for measuring the plasma concentration of Cor,E,NE at each time point; and intubation time, rate of successful intubation, nasal bleeding, and incidences of complications during intubation such as hypertension, tachycardia and myocardial ischemia were recorded.Results Compared with T0, MAP and HR at T1,T2 in both groups, and MAP at T3 in group A were increased, the plasma concentrations of E, NE and Cor at T1,T2 in both groups and the plasma concentrations of E, NE and Cor at T3 in group A were increased(P0.05). Compared with group A, MAP, HR at T1,T2 and MAP at T3 in group B were decreased, the plasma concentrations of E, NE and Cor in group B at T1,T2,T3 were decreased(P0.05). The intubation time was shorten, the rate of successful intubation was higher, incidences of hypertension, tachycardia and myocardial ischemia were lower, and the number of nasal bleeding during intubation was lower in group B.Conclusion Nasotracheal intubation assisted by FOB can inhibit the stress reaction in patients with OSAS.