Doherty Jane S, Froom Stephen R, Gildersleve Christopher D
Department of Anaesthetics and Intensive Care Medicine, University Hospital of Wales, Cardiff, UK.
Paediatr Anaesth. 2009 Jul;19 Suppl 1:30-7. doi: 10.1111/j.1460-9592.2009.03001.x.
This review summarizes the evolution of the pediatric laryngoscope using some of the established landmarks in the history of anesthesia. Children were rarely intubated before 1940 though the subsequent 30 years saw a proliferation of pediatric laryngoscopes in part driven by the developments in pediatric anesthesia and surgery, manufacturing techniques and materials and a change in airway management philosophy exemplified by Jackson Rees's argument against the notion that intubation was to be avoided in children. A perspective on the present day describes the modifications to popular straight and curved blade laryngoscopes and the development of new devices that enhance direct visualization of the larynx. There are an ever-increasing number of laryngoscope devices that assist in indirect visualization of the larynx such as rigid optical stylets and flexible fiber-optic scopes. Images from many of these devices may be enhanced by digital camera or real-time video technology. The prospect of future laryngoscope development is glimpsed in the arrival of light emitting diode light source technology and questions remain regarding the consequences of equipment disposability and at the fidelity of disposable equipment manufacture.
本综述利用麻醉史上一些既定的里程碑事件,总结了小儿喉镜的发展历程。1940年以前,儿童很少进行插管操作,不过在随后的30年里,小儿喉镜大量涌现,部分原因是小儿麻醉与外科手术的发展、制造技术与材料的进步,以及气道管理理念的转变,杰克逊·里斯反对儿童应避免插管这一观念,就是这种转变的例证。对当今情况的展望描述了对常用直型和弯型叶片喉镜的改进,以及有助于直接观察喉部的新设备的开发。有越来越多的喉镜设备可辅助间接观察喉部,如硬式光学探条和柔性纤维光学镜。其中许多设备的图像可通过数码相机或实时视频技术得到增强。发光二极管光源技术的出现让人瞥见了未来喉镜发展的前景,而设备一次性使用的后果以及一次性设备制造的保真度等问题依然存在。