Department of Anesthesiology and Intensive Care, Thoraxklinik, University Hospitals, Amalienstr.5, Heidelberg D-69126, Germany.
Department of Anesthesiology and Intensive Care, Thoraxklinik, University Hospitals, Amalienstr.5, Heidelberg D-69126, Germany.
Thorac Surg Clin. 2014 Feb;24(1):13-25. doi: 10.1016/j.thorsurg.2013.10.001.
Tracheobronchial surgery constitutes a challenge to the anesthetist because it involves the anatomic structures dedicated to bulk gas transport. Common approaches to airway management and gas exchange for extrathoracic and intrathoracic airway surgery are reviewed, with due regard to less common methods thought crucial for specific procedures. Tracheal surgery, beyond sharing the airways, requires sharing with the surgeon ideas on preoperative assessment, on the impact on gas exchange of induction across compromised airways, and of emergence from anesthesia with airways altered by surgical repair. Mutual understanding is essential to prevent, rapidly identify, and correct imminent loss of airway viability.
气管支气管手术对麻醉师来说是一个挑战，因为它涉及到专门用于大容量气体输送的解剖结构。本文回顾了胸外和胸内气道手术的气道管理和气体交换的常见方法，并适当考虑了一些认为对特定手术至关重要的不太常见的方法。气管手术除了共享气道外，还需要与外科医生共同探讨术前评估、经受损气道诱导对气体交换的影响，以及在气道因手术修复而改变的情况下从麻醉中苏醒等问题。为了防止、快速识别和纠正即将发生的气道丧失的风险，相互理解至关重要。
