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右美托咪定在一位颈椎严重病变患者清醒状态下纤维光导插管和自行定位中的应用,该患者需要进行颅后窝肿瘤切除术。

Dexmedetomidine for awake fibreoptic intubation and awake self-positioning in a patient with a critically located cervical lesion for surgical removal of infra-tentorial tumour.

机构信息

Neuroanaesthesia, National Institute of Mental Health & Neurosciences, Bangalore, India.

出版信息

Anaesthesia. 2010 Sep;65(9):949-51. doi: 10.1111/j.1365-2044.2010.06411.x.

Abstract

Cervical lesions compressing the spinal cord pose a significant risk of exacerbating the existing neurological condition during tracheal intubation and subsequent positioning. Awake fibreoptic-assisted intubation is a suitable option in such situations. We describe how the use of dexmedetomidine for sedation during awake fibreoptic intubation also facilitated self-positioning before surgery in a patient with a cervical cord compressive lesion and raised intracranial pressure undergoing excision of a cerebellopontine angle lesion in the lateral position, without any adverse neurological outcome.

摘要

颈椎病变压迫脊髓会增加气管插管和随后体位改变时原有神经状况恶化的风险。清醒状态下纤维光导辅助插管是这种情况下的合适选择。我们描述了在一名颈椎压迫性病变和颅内压升高的患者中,使用右美托咪定镇静辅助清醒纤维光导插管,如何在不引起任何不良神经后果的情况下,便于患者在手术前自行摆好体位,以便在侧卧位下切除桥小脑角病变。

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