Miyazawa N, Shigematsu T, Kaneko S, Tabuchi H, Yorozu T, Saito N, Tashiro M
Department of Anesthesiology, Tokyo Metropolitan Ohtuka Hospital.
Masui. 1992 Feb;41(2):263-9.
The Bullard laryngoscope is an anatomically shaped rigid fiber optic instrument designed for indirect laryngoscopy and intubation. It requires no neck extension nor flexion to perform laryngeal intubation. This characteristic is especially useful in the case of difficult airway. The Bullard laryngoscope, however, with which it is easy to visualize the cords, has not been popular yet, because using the intubating forceps mechanism requires a certain amount of skill. The intubation method developed by us with Bullard laryngoscope has been tried on 26 patients with difficult airway and ten patients with normal airway. An endotracheal tube is inserted through nostril, and intubation is performed viewing the tube and larynx during all the processes of intubation. Three kinds of endotracheal tubes, i.e. Magill type plain tubes, styletted tubes, and directional tip tubes, are compared. The method using a directional tip tube (Endotrol) is concluded as the best among them. The Endotrol tube itself has such a suitable shape for nasal intubation that it can be introduced to the larynx with little directional change. Therefore, our method is mastered with a shorter training period than the intubation method with fiber-optic laryngoscopes. In conclusion, our intubation method with the Bullard laryngoscopes using the directional tip tubes (Endotrol) is useful for patients with difficult airways, and is also nontraumatic and easy to perform.
Bullard喉镜是一种具有解剖学形状的刚性光纤器械，设计用于间接喉镜检查和插管。进行喉镜插管时无需伸展或弯曲颈部。这一特性在困难气道的情况下特别有用。然而，尽管使用Bullard喉镜很容易看到声带，但它尚未普及，因为使用插管钳机制需要一定的技巧。我们用Bullard喉镜开发的插管方法已在26例困难气道患者和10例气道正常的患者身上进行了试验。通过鼻孔插入气管导管，并在插管的全过程中观察导管和喉部进行插管。比较了三种气管导管，即Magill型普通导管、带管芯导管和定向头端导管。结果得出使用定向头端导管（Endotrol）的方法是其中最好的。Endotrol导管本身具有适合鼻插管的形状，几乎无需改变方向就能插入喉部。因此，与使用纤维喉镜的插管方法相比，我们的方法在更短的训练时间内就能掌握。总之，我们使用定向头端导管（Endotrol）的Bullard喉镜插管方法对困难气道患者有用，而且无创且易于操作。
