Abstract
OBJECTIVE: The objective of this study is to examine the success rate of transesophageal echocardiography (TEE) probe placement and the incidence of postoperative odynophagia based on pre-assessing the exposed position of the esophageal opening within the pharyngeal cavity. METHODS: Sixty-four patients scheduled for elective cardiac surgery under general anesthesia, with a requirement for transesophageal echocardiography (TEE) monitoring, were enrolled in this study. The patients were randomly assigned to either a pre-observation group or a conventional group. In the pre-observation group, the pharyngeal cavity was examined using a video laryngoscope during endotracheal intubation, and the TEE probe was inserted along the pre-observed esophageal opening. In the conventional group, the probe was inserted using the standard blind insertion technique. The number of insertion attempts and the time required for probe placement were recorded, with three unsuccessful attempts defined as a placement failure. Postoperative odynophagia was assessed in patients on postoperative days 1, 3, 5, and 7, with both the severity and duration of the condition being monitored. RESULTS: All 64 patients successfully completed the study, with no statistically significant differences observed between the two groups in terms of basic demographic data, risk classification, or oropharyngeal grading. The pre-observation group demonstrated a significantly higher first-attempt success rate compared to the conventional group (78% vs. 22%; Odds Ratio [OR], 17.54; 95% CI, 3.86 to 83.33; P < 0.001). Additionally, the numeric rating scale (NRS) scores for odynophagia on postoperative days 1, 3, 5, and 7, as well as the duration of odynophagia, were significantly lower in the pre-observation group than in the conventional group (P < 0.05). The incidence of postoperative odynophagia was also significantly reduced in the pre-observation group compared to the conventional group (P < 0.001). CONCLUSION: The pre-observation group achieved a higher first-attempt success rate for probe placement compared to the conventional group, with patients experiencing less severe and shorter-lasting postoperative odynophagia, indicating significant advantages over the conventional blind insertion technique.