Wender R, Goldman A J
Univerisity of Washington, Department of Anaesthesiology, MS 356540, 1959 NE Pacific Street, Seattle, WA 98195, USA.
Anaesthesia. 2007 Sep;62(9):948-51. doi: 10.1111/j.1365-2044.2007.05127.x.
The Intubating Laryngeal Mask Airway (ILMA) is a supraglottic airway that facilitates ventilation and blind tracheal intubation. The LMA CTrach is functionally identical to the ILMA, but has an integrated fibreoptic bundle that provides a view of the larynx. This enables visualisation of tracheal intubation while delivering 100% oxygen, with or without an inhalational anaesthetic. We report awake insertion of the CTrach in three morbidly obese patients (BMI 60-63) with known or anticipated difficult airways. Pre-operatively, patients were given midazolam and glycopyrrolate intravenously, and then in the operating theatre the airway was anaesthetised with topical lidocaine 4%. The CTrach was inserted into the oropharynx of the still-awake patient, the vocal cords were visualised, and anaesthetic induction was commenced with sevoflurane and spontaneous ventilation. Neuromuscular blockers were not used and we were able to see the vocal cords during the entire anaesthetic induction and intubation.
气管插管喉罩气道（ILMA）是一种声门上气道装置，可便于通气和盲目气管插管。LMA CTrach在功能上与ILMA相同，但具有集成的光纤束，可提供喉部视野。这使得在输送100%氧气时，无论是否使用吸入麻醉剂，都能可视化气管插管。我们报告了在三名已知或预期气道困难的病态肥胖患者（BMI 60 - 63）中清醒插入CTrach的情况。术前，患者静脉注射咪达唑仑和格隆溴铵，然后在手术室用4%的利多卡因局部麻醉气道。将CTrach插入仍清醒患者的口咽，可视化声带，然后用七氟醚和自主通气开始麻醉诱导。未使用神经肌肉阻滞剂，并且在整个麻醉诱导和插管过程中我们都能看到声带。
