Kato Takahiro, Kusunoki Shinji, Kawamoto Masashi, Yuge Osafumi
Department of Anesthesiology and Critical Care, Hiroshima University Hospital Hiroshima 734-8551.
Masui. 2007 Oct;56(10):1179-81.
The AirWay Scope (AWS; PENTAX Corporation, Tokyo, Japan) is a newly developed rigid video laryngoscope with a built-in LCD monitor that provides accurate verification of tube passage through the vocal cords during tracheal intubation procedures. The blade is shaped to fit the oropharyngeal anatomy, which enables operators to achieve an optimal view for tracheal intubation without requiring alignment of the oral, pharyngeal, and laryngeal axes. We used an AWS for awake intubation in a 34-year-old male burn patient with a difficult airway under conscious sedation obtained with infusion of dexmedetomidine (DEX). Following topical anesthesia of the upper airway and preoxygenation, sedation was induced with 6 microg kg(-1) hr(-1) of DEX for 13 minutes and maintained at 0.5 microg kg(-1) hr(-1). Thereafter, insertion of the AWS gave a Cormack grade 1 glottic view, and endotracheal anesthesia was provided by use of a modified spray tube through the AWS blade without patient anxiety or discomfort. The trachea was intubated using the AWS without respiratory depression or other complications while the patient was sedated (Ramsay sedation scale class 4). We consider the AWS to be useful for awake tracheal intubation in patients with a difficult airway.
气道视镜(AWS;日本东京宾得公司)是一种新开发的硬质视频喉镜,带有内置液晶显示器,可在气管插管过程中准确确认导管通过声带情况。其叶片形状适合口咽解剖结构,使操作者无需使口、咽和喉轴对齐就能获得气管插管的最佳视野。我们对一名34岁男性烧伤患者使用AWS进行清醒插管,该患者气道困难,通过输注右美托咪定(DEX)实现了清醒镇静。对上气道进行表面麻醉和预充氧后,以6微克/千克(-1)小时(-1)的DEX诱导镇静13分钟,然后维持在0.5微克/千克(-1)小时(-1)。此后,插入AWS获得了Cormack 1级声门视野,通过AWS叶片使用改良喷雾管进行气管内麻醉,患者未出现焦虑或不适。在患者镇静状态下(Ramsay镇静评分4级),使用AWS进行气管插管,未出现呼吸抑制或其他并发症。我们认为AWS对气道困难患者的清醒气管插管有用。