Abstract:Objective To investigate the application of fiberoptic bronchoscopy guided combined anesthesia under awake intubation in ankylosing spondylitis patients. Methods From February 2017 to August 2020, 43 patients with ankylosing spondylitis underwent posterior osteotomy and orthopedics in Nanjing Drum Tower Hospital were randomly divided into group P (21 cases) and group L (22 cases). Patients in group P were given lidocaine aerosol throat spray, and patients in group L were given topical anesthesia with lidocaine for glottis and main trachea through bronchoscopy. HR, MAP and SpO2 were compared between the two groups at the time entering the room (T₁), before endotracheal intubation (T₂), immediately after endotracheal intubation (T₃), 1 min after endotracheal intubation (T₄) and 3 min after endotracheal intubation (T₅). The time of intubation, the first intubation success rate and intubation-related complications were recorded. Results Compared with T₁, HR and MAP increased at T₃-T₅ in two groups (P<0.05). Compared with group L, HR and MAP increased at T₃－T₅ in group P (P<0.05); Compared with T₁, SpO2 decreased at T₄-T₅ in group P (P<0.05); Compared with group L, SpO2 decreased at T₄-T₅ in group P (P<0.05). The tracheal intubation time of group L was shorter than that of group P ［(45.8±8.8) s vs (71.0±10.1) s，P<0.01］, and the success rate of first tracheal intubation was higher than that of group P (90.9% vs 47.6%，P<0.01). The incidence of oropharyngeal bleeding and sore throat caused by tracheal intubation in group P was higher than those in group L (P<0.05).Conclusion Fiberoptic bronchoscopy guided combined anesthesia can effectively reduce the stress response and reduce intubatio-related complications in patients with ankylosing spondylitis awake endotracheal intubation.