目的 观察超声引导下喉上神经阻滞（SLNB）联合纳布啡在清醒气管插管中的临床应用效果。方法 选取2023年10月—2025年4月进行清醒气管插管的60例患者,按随机数字表法分为对照组（n=30）和研究组（n=30）。两组患者均行超声引导下SLNB,研究组在此基础上静脉注射纳布啡。比较两组患者插管情况（首次插管成功率、平均插管时间、呛咳发生率）,入室后3 min（T1）、插管即刻（T2）、插管后3 min（T3）血流动力学指标[心率（HR）、血氧饱和度（SpO₂）及平均动脉压（MAP）],术后并发症（吞咽困难、神经损伤等]发生率,患者配合度、舒适度情况。结果 研究组首次插管成功率（93.33%）高于对照组（70.00%）,平均插管时间[（36.28±4.26） min]短于对照组[（41.25±4.53） min],呛咳发生率（3.33%）低于对照组（20.00%）,差异均有统计学意义（P<0.05）。T1时刻两组HR、SpO_2、MAP比较,差异均无统计学意义（P>0.05）; T2及T3时刻,研究组MAP、HR均低于对照组,SpO₂高于对照组,差异有统计学意义（均P<0.05）。研究组术后吞咽困难、神经损伤等并发症发生率为6.67%,明显低于对照组的26.67%（P<0.05）。研究组患者清醒插管舒适度、耐受度及满意度评分均低于对照组,差异有统计学意义（均P<0.05）。结论 超声引导下SLNB联合纳布啡在清醒气管插管中能够有效提高插管成功率,维持血流动力学稳定,降低术后并发症的发生,改善患者的舒适度和配合度。

Objective To evaluate the clinical utility of ultrasound-guided superior laryngeal nerve block （SLNB） combined with nalbuphine during awake tracheal intubation procedures. Methods A total of 60 patients undergoing awake tracheal intubation from October 2023 to April 2025 were selected and randomly divided into a control group （n=30） and a study group （n=30） using a random number table. Both groups underwent ultrasound-guided SLNB, and the study group was given intravenous nalbuphine on this basis. Intubation conditions （first-attempt intubation success rate, average intubation time, and incidence of coughing）, hemodynamic indexes [heart rate （HR）, oxygen saturation （SpO₂）, and mean arterial pressure （MAP）] at 3 min after entering the opration room （T1）, immediately after intubation （T2）, and 3 min after intubation （T3）, incidence of postoperative complications （dysphagia, nerve injury, etc.）, and patient compliance and comfort were compared between the two groups. Results The success rate of the first-attempt intubation in the study group was 93.33%, which was higher than 70.00% in the control group; the average intubation time of the study group was （36.28±4.26） min, shorter than （41.25±4.53） min of the control group; the incidence of coughing in the study group was 3.33%, lower than 20.00% in the control group, all with statistically significant differences （P<0.05）. At T1, HR, SpO₂, and MAP between the two groups revealed no statistically significant differences （P>0.05）. At T2 and T3, the study group exhibited significantly lower MAP and HR alongside higher SpO_₂ than the control group （P<0.05）. The incidence of postoperative complications such as dysphagia and nerve injury in the study group was 6.67%, significantly lower than 26.67% in the control group （P<0.05）. Scores of comfort, tolerance, and satisfaction with awake intubation in the study group were all higher than those in the control group, with statistically significant differences （P<0.05）. Conclusion Ultrasound-guided SLNB combined with nalbuphine in awake tracheal intubation can effectively improve the success rate of intubation, maintain hemodynamic stability, reduce the incidence of postoperative complications, and improve the comfort and compliance of patients.