Kino Atsunari, Hirata Shinichi, Mishima Seigo
Department of Anesthesia, Otsu Municipal Hospital, Otsu 520-0804.
Masui. 2009 Nov;58(11):1430-2.
In 1998, Dr. Larson described the technique of applying pressure to the "laryngospasm notch" as the best treatment for laryngospasm. Yet, there are no case reports of using this technique in the literature. We report 2 cases of using this technique in patients whose oxygen saturation levels dropped after tracheal extubation. The first patient was a 48-year-old man who underwent laparoscopic cholecystectomy and the second patient was a 67-year-old man who underwent lumbar laminectomy. In both cases, induction of general anesthesia and surgery were uneventful. After surgery, we confirmed spontaneous respiration and the patients were able to respond and shake hands. However, immediately after extubation, the patients could not breathe and their oxygen saturation levels decreased to 76% and 84%, respectively. In the first patient, mask ventilation was easy and we used the "laryngospasm notch" technique during ventilation. However, in the second patient, mask ventilation was difficult and we used this technique prepared for re-intubation. In both cases, the patients began to breathe spontaneously shortly after using this technique and oxygen saturation increased to 100%. The incidence of laryngospasm is higher after tracheal extubation. The "laryngospasm notch" method is a good technique to treat this condition.
1998年，拉尔森博士将对“喉痉挛切迹”施加压力的技术描述为治疗喉痉挛的最佳方法。然而，文献中尚无使用该技术的病例报告。我们报告了2例在气管拔管后氧饱和度下降的患者中使用该技术的情况。第一例患者是一名48岁男性，接受了腹腔镜胆囊切除术；第二例患者是一名67岁男性，接受了腰椎椎板切除术。在这两例病例中，全身麻醉诱导和手术过程均顺利。术后，我们确认患者自主呼吸，且患者能够做出反应并握手。然而，拔管后立即出现患者无法呼吸的情况，其氧饱和度分别降至76%和84%。在第一例患者中，面罩通气容易，我们在通气过程中使用了“喉痉挛切迹”技术。然而，在第二例患者中，面罩通气困难，我们为再次插管准备时使用了该技术。在这两例病例中，使用该技术后不久患者均开始自主呼吸，且氧饱和度升至100%。气管拔管后喉痉挛的发生率较高。“喉痉挛切迹”方法是治疗这种情况的一种好技术。
