使用可弯曲支气管镜进行困难气道插管
Difficult airway intubation with flexible bronchoscope.
作者信息
Rodrigues Ascedio Jose, Scordamaglio Paulo Rogério, Palomino Addy Mejia, Oliveira Eduardo Quintino de, Jacomelli Marcia, Figueiredo Viviane Rossi
机构信息
MD, Assistant Physician, Division of Respiratory Endoscopy, Hospital das Clínicas, Universidade de São Paulo, SP, Brazil.
MD, Assistant Physician, Division of Respiratory Endoscopy, Hospital das Clínicas, Universidade de São Paulo, SP, Brazil.
出版信息
Braz J Anesthesiol. 2013 Jul-Aug;63(4):358-61. doi: 10.1016/j.bjane.2012.05.001. Epub 2013 Aug 13.
BACKGROUND AND OBJECTIVE
To describe the efficacy and safety of a flexible bronchoscopy intubation (FBI) protocol in patients with difficult airway.
METHOD
We reviewed the medical records of patients diagnosed with difficult airway who underwent flexible bronchoscopy intubation under spontaneous ventilation and sedation with midazolam and fentanyl from March 2009 to December 2010.
RESULTS
The study enrolled 102 patients, 69 (67.7%) men and 33 (32.3%) women, with a mean age of 44 years. FBI was performed in 59 patients (57.8%) with expected difficult airway in the operating room, in 39 patients (38.2%) in the Intensive Care Unit (ICU), and in 4 patients (3.9%) in the emergency room. Cough, decrease in transient oxygen saturation, and difficult progression of the cannula through the larynx were the main complications, but these factors did not prevent intubation.
CONCLUSION
FBI according to the conscious sedation protocol with midazolam and fentanyl is effective and safe in the management of patients with difficult airway.
背景与目的
描述一种用于困难气道患者的可弯曲支气管镜插管（FBI）方案的有效性和安全性。
方法
我们回顾了2009年3月至2010年12月期间诊断为困难气道且在咪达唑仑和芬太尼镇静下自主通气时接受可弯曲支气管镜插管的患者的病历。
结果
该研究纳入了102例患者，其中男性69例（67.7%），女性33例（32.3%），平均年龄44岁。59例（57.8%）预计气道困难的患者在手术室接受了FBI，39例（38.2%）在重症监护病房（ICU）接受，4例（3.9%）在急诊室接受。咳嗽、短暂血氧饱和度下降以及插管通过喉部困难是主要并发症，但这些因素并未妨碍插管。
结论
按照咪达唑仑和芬太尼的清醒镇静方案进行FBI在困难气道患者的管理中是有效且安全的。
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