Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Seoul, Korea.
Korean J Anesthesiol. 2012 Mar;62(3):272-6. doi: 10.4097/kjae.2012.62.3.272. Epub 2012 Mar 21.
Patients with cervical spine instability and limited range of motion are challenge to anesthesiologists. It is important to consider alternatetive methods for securing the airway while maintaining neutral position and minimizing neck motion, because these patients are at increased risk for tracheal intubation failure and neurologic injury during airway management or position change. We experienced two cases that patients had cervical spine instability and severe limited range of motion due to the fusion of the entire cervical spine. One patient was a 6-year-old girl weighing 12.7 kg and had Klippel-Feil syndrome with Arnold-Chiari malformation, the other was a 24-year-old female weighing 31 kg and had juvenile rheumatoid arthritis. We successfully performed the intubation by using the fiberoptic intubation though a laryngeal mask airway in these two cases.
患有颈椎不稳定和活动范围受限的患者对麻醉师来说是一个挑战。在保持中立位和最小化颈部运动的同时，考虑替代方法来确保气道通畅非常重要，因为这些患者在气道管理或体位改变期间气管插管失败和神经损伤的风险增加。我们遇到了两例因整个颈椎融合而导致颈椎不稳定和严重活动受限的患者。一例是一名 6 岁、体重 12.7 公斤的女孩，患有 Klippel-Feil 综合征和 Arnold-Chiari 畸形，另一例是一名 24 岁、体重 31 公斤的女性，患有幼年特发性关节炎。我们通过在这两例患者中使用喉罩气道进行纤维支气管镜插管成功地进行了插管。
