| Obejective This study examines the sensitivity of oropharynx by numerical rating scale method and establishs a sensitive map of oropharynx,laying concrete foundations for designing improved oropharyngeal airway that enhances patient tolerance level.On the basis of the sensitivity map of the oropharynx,the new oropharyngeal airway with better tolerance and smooth airway was designed by modifying the morphological structure of the traditional Guedel oropharyngeal airway.Methodology 1?92 subjects,averagely 29± 6 years.old,are eligible.The trial begins when subjects are calmly seated.Firstly we record the initial heart rate with a finger-clamp pulse oximeter,and instruct subjects to raise head and open mouth After tapping the control point to inform this that it is a 0-point value,we use a cotton swab to gently touch different points in their mouths(33 points in total),where the longest touching time lasts 5 seconds.Next,subjects use the Oropharynx Stimulate Reflection Sensitivity Score table to grade each point at end of touch and the finger-clamp pulse oximeter keeps track of their heart rate.Together with subjects'grading their receptivity and tester recording the duration and heart rate at each point,special feelings or impulses towards coughing,vomiting,and lacrimation are also inquired and documented.The score interval 1s ranging from 0 to 10 according to discomfortableness,where 0 is the control point and 10 denotes the most discomfort.The higher the score,the more sensitive the patient is to the adverse reflexes of the stimulus.The collected measurement data is expressed as mean±standard deviation(?-±s).The scores,tolerance time and heart rate of different points in the group are analyzed by one-way analysis of variance.We apply 95%confidence level here to indicate statistical significance.2.?Based on the traditional Guedel oropharyngeal airxway,the aerodynamic principle such as Bernoulli equation 1s used to analyze and improve the structural design,and a new type of oropharyngeal ventilation with good tolerance,oxygen absorption and high comfort 1s designed.Results 1?Comparison of test results of digital scoring method for measuring oropharyngeal sensitivity:Among the 92 volunteer subjects,the overall average is X?1.81,the highest scored point is 4,?-=1.81,the center point of the Posterior pharynx.and the lowest point is 5 =0.56,which 1s the point 26 and 32 of the lingual area.The average score is 4,10,11,and 12 at the point of 4-5 points.The average score is 3-4 points,and the points are 2,5,and 6.The average score is 2-3 points.7.The average score is 1-2 points for points 8,9,15,16,18,20,24,25.The points l,2,3,4,5 6,and 7,10,11,12 obtain average score of 2.5 or higher and their scores are statistically significantly different from scores of other points(P<0.05).Points 10,11,12(root of the tongue)and points 1,2,3 5 5,6,7(soft palate)'s scores are statistically different(P<0.05).More specifically,grading of points 10,11,12 surpass the grading of point 1 to 7.However,there is no statistically significant difference in the scores between point 4 and points 10,11,and 12,and no statistically significant differences between the corresponding points(such as 2 and 6,3 and 5,10 and 12).In terms of subareas,Points in soft palate gains signifieantly higher scores than those in hard palate,tongue and cheek(P<0.05).No statistically significant distinction 1s found between the hard palate area(except point 7),the cheeks,and the tongue(except the tongue root points 10,11,and 12).We cannot conclude which one is more sensitive than others in these areas.2?Comparison of the results of tolerance time at each point:In the tolerance duration,the average tolerance time of point 4,10,11,and 12 significantly differs from the other 29 points whose tolerance time are significantly higher(P<0.05).But no significant difference 1s detected among points 4,10,11,and 12 points.The average tolerated time of point 4 is the shortest,which is ?-=4.25.However,there is no statistically significant difference between 4,10,11,and 12 points.The tolerance time of all other points exceeds 4 seconds.Except for point 18,each point of 7-9 and 13-33 reach the longest tolerance time of the test set of 5 seconds.3?Comparison of changes in heart rates:In the trial,the heart rate increased when soft palate area(points 1,2,3,4,5,6)and the base of the tongue(points 10,11,12)are touched,but the changes are not obvious.When stimulating other points,heart rate barely changes or has a tendency to returm to the initial heart rate or decrease even lower.4?Design of new oropharyngeal airway:"half-type oxygen-absorbing oropharyngeal airway",effectively-support-type oxygen inhalation and sputum aspiration oropharyngeal airway device",have applied for national patents.Conclusion The posterior pharynx is the most sensitive area in the oropharynx,followed by the soft palate area.Avoidance or reduction in stimulus of these two areas will improve patient's tolerance level when designing the oropharyngeal airway. |
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