Kaza Sangita R, Maddali Madan M, Albahrani Maher J, Vaghari Adel A
Department of Anesthesia, Royal Hospital, Muscat, Oman.
Indian J Anaesth. 2012 Nov;56(6):567-9. doi: 10.4103/0019-5049.104578.
One-lung ventilation for a thoracotomy procedure was achieved with the help of a endobronchial blocker in a young girl with limited mouth opening, minimal neck extension, and a distorted tracheo-bronchial anatomy. As the patient would not cooperate for an awake nasotracheal intubation despite adequate preperation, an inhalational anesthetic was used to make the patient unconscious, taking care that spontaneous breathing was maintained. Nasotracheal intubation was done with the help of a fiberoptic bronchoscope. A wire-guided Arndt endobronchial blocker was placed coaxially through the endotracheal tube using a fiberoptic bronchoscope. This case report highlights that in a scenario of both upper and lower airway distortion, a bronchial blocker positioned through a nasotracheal tube under fiberoptic guidance might be the best option when one-lung ventilation is required.
在一名口开度有限、颈部伸展度极小且气管支气管解剖结构扭曲的年轻女孩身上，借助支气管内封堵器实现了开胸手术的单肺通气。尽管准备充分，但患者仍不配合清醒状态下的经鼻气管插管，于是使用吸入性麻醉剂使患者失去意识，同时注意维持自主呼吸。在纤维支气管镜的辅助下进行了经鼻气管插管。使用纤维支气管镜将钢丝引导的阿恩特支气管内封堵器同轴穿过气管导管置入。本病例报告强调，在上下气道均扭曲的情况下，当需要单肺通气时，在纤维支气管镜引导下经鼻气管导管置入支气管封堵器可能是最佳选择。
