Abstract: 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.

Key words: Ultrasound-guided superior laryngeal nerve block, Nalbuphine, Awake tracheal intubation, Hemodynamics