Meschino A, Devitt J H, Koch J P, Szalai J P, Schwartz M L
Department of Anaesthesia, Sunnybrook Health Science Centre, University of Toronto, Ontario.
Can J Anaesth. 1992 Feb;39(2):114-7. doi: 10.1007/BF03008639.
As a referral centre for cervical spine injuries, we have routinely performed awake tracheal intubation when intubation was indicated. A retrospective case control study was undertaken to review the frequency of neurological deterioration and aspiration associated with our approach. Neurological deterioration was assessed by a change in level of injury or neurological grade at admission and discharge. Four hundred and fifty-four patients with critical cervical spine and/or cord injuries were reviewed over an eight-year period. A case group of 165 patients underwent tracheal intubation awake within two months of injury. A control group of 289 remained unintubated during the same period. A comparison of spinal neurological status between admission and discharge revealed no statistically significant difference in neurological deterioration between the two groups. This occurred despite a greater injury severity score in the case group. No evidence of aspiration during intubation was documented. We conclude that awake tracheal intubation is a safe method of airway management in patients with cervical spine injuries.
作为颈椎损伤的转诊中心，当有插管指征时，我们常规进行清醒气管插管。我们进行了一项回顾性病例对照研究，以评估与我们的方法相关的神经功能恶化和误吸的发生率。通过入院时和出院时损伤程度或神经分级的变化来评估神经功能恶化。在八年期间对454例严重颈椎和/或脊髓损伤患者进行了回顾。病例组165例患者在受伤后两个月内进行了清醒气管插管。对照组289例在同一时期未进行插管。入院和出院时脊髓神经状态的比较显示，两组之间神经功能恶化没有统计学上的显著差异。尽管病例组的损伤严重程度评分更高，但仍出现这种情况。插管期间未记录到误吸的证据。我们得出结论，清醒气管插管是颈椎损伤患者气道管理的一种安全方法。
