Roberts J T
Department of Anaesthesia, Massachusetts General Hospital, Boston 02114.
J Clin Anesth. 1991 Jan-Feb;3(1):64-75. doi: 10.1016/0952-8180(91)90210-e.
To describe a current method of teaching flexible fiber-optic laryngoscopy.
Review of a current technique.
Inpatient surgery area at a university medical center.
More than 1,000 ASA physical status I and II patients requiring general endotracheal anesthesia for renal lithotripsy were intubated orally using a flexible fiber-optic laryngoscope.
Patients were given a sleep dose of thiopental sodium (4 mg/kg) and paralyzed with a bolus of succinylcholine (1 mg/kg).
Peripheral oxygen (O2) saturation, capnography, electrocardiography (EKG), automated blood pressure (BP) measurements, and clinical response of the patients were closely monitored by the attending anesthesiologist. Three obese patients rapidly desaturated, leading to abandonment of the technique for teaching purposes. After ventilation with 100% O2, all 3 patients were rapidly intubated orally by the instructor using the flexible fiber-optic technique.
Oral flexible fiber-optic laryngoscopy and intubation may be taught safely using thiopental sodium and succinylcholine by adhering to the guidelines outlined in this paper.
描述一种当前教授可弯曲纤维喉镜检查的方法。
对当前技术的回顾。
一所大学医学中心的住院手术区域。
1000多名因肾结石碎石术需要全身气管内麻醉的美国麻醉医师协会（ASA）身体状况I级和II级患者，使用可弯曲纤维喉镜经口插管。
给患者静脉注射硫喷妥钠睡眠剂量（4毫克/千克），并静脉推注琥珀酰胆碱（1毫克/千克）使其麻痹。
主麻医师密切监测患者的外周血氧（O2）饱和度、二氧化碳描记图、心电图（EKG）、自动血压（BP）测量值以及临床反应。3名肥胖患者迅速出现氧饱和度下降，导致出于教学目的放弃该技术。在给予100%氧气通气后，带教老师使用可弯曲纤维喉镜技术迅速为所有3名患者经口插管。
按照本文所述指南，使用硫喷妥钠和琥珀酰胆碱可以安全地教授经口可弯曲纤维喉镜检查及插管技术。
