Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53597, USA.
J Clin Anesth. 2012 Aug;24(5):412-4. doi: 10.1016/j.jclinane.2011.11.009. Epub 2012 May 31.
A 77 year old, nasally intubated man with a history of repeated episodes of airway obstruction requiring intubation due to recurrent laryngitis and a hypopharyngeal mass, needed nasotracheal-to-orotracheal tube exchange. The GlideScope videolaryngoscope was inserted, achieving a full view of the glottic inlet with the nasotracheal tube in situ. An endotracheal tube (ETT) loaded on a GlideRite Rigid Stylet was advanced through the oropharynx into view. Advancement of this ETT to the glottic opening was tested and achieved. With both tracheal tubes in view, the nasotracheal tube cuff was deflated and withdrawn from the glottic opening. While maintaining videoscopic visualization, the orotracheal tube was advanced through the vocal cords into the trachea. The benefits of this technique versus existing alternatives are discussed.
一位 77 岁的男性患者，因复发性喉炎和下咽肿块导致气道阻塞反复发作，需要进行经鼻气管插管至经口气管插管的更换。插入 GlideScope 视频喉镜，在原位经鼻气管插管时可充分观察声门入口。将装有 GlideRite 刚性塑形导丝的气管插管通过口咽进入视野。测试并成功将此气管插管推进至声门开口处。在观察到两个气管插管的同时，将经鼻气管插管的套囊放气并从声门开口处抽出。在保持视频镜可视化的同时，将经口气管插管推进通过声带进入气管。讨论了与现有替代方法相比，该技术的优势。
