Piepho T, Thierbach A, Werner C
Department of Anesthesiology, Johannes Gutenberg-University, Langenbeckstrasse 1, Mainz 55131, Germany.
Br J Anaesth. 2005 Jun;94(6):859-60. doi: 10.1093/bja/aei146. Epub 2005 Apr 15.
Nasotracheal intubation is frequently used for airway management during maxillofacial surgery. Complications such as haemorrhage occur more frequently with this route of intubation than with the orotracheal route. This case report describes a male patient aged 51 yr who developed severe epistaxis after the tube had passed the nares. As an additional complication laryngoscopy and endotracheal intubation failed because of difficult airway (Cormack-Lehane grade 4). Attempts using an intubating laryngeal mask airway and a Bonfils intubating fibrescope did not succeed. The airway was finally managed by cricothyroidotomy. A modified sequence of nasotracheal intubation is proposed to avoid similar life-threatening complications.
在颌面外科手术中，鼻气管插管常用于气道管理。与经口气管插管相比，通过这种插管途径发生出血等并发症的频率更高。本病例报告描述了一名51岁男性患者，在导管通过鼻孔后发生了严重鼻出血。作为另一种并发症，由于气道困难（Cormack-Lehane 4级），喉镜检查和气管插管失败。使用插管喉罩气道和邦菲尔斯插管纤维喉镜的尝试均未成功。最终通过环甲膜切开术处理气道。提出了一种改良的鼻气管插管顺序，以避免类似的危及生命的并发症。
