Saheb Shaik Mastan, Nath Vemuri Nagendra, Kumar K Phani, Padmaja Pilli Parama Geetha
Department of Anaesthesiology, NRI Academy of Sciences, Guntur, Andhra Pradesh, India.
Oralmaxillofacial Surgery, NRI Academy of Sciences, Guntur, Andhra Pradesh, India.
Indian J Anaesth. 2014 Jan;58(1):48-50. doi: 10.4103/0019-5049.126795.
Airway management is a challenge to anesthesiologists particularly in maxillofacial surgeries. The oral tracheal tube is unsuitable because it interferes with the surgical field and prevents dental occlusion. Nasotracheal intubation may not always be possible due to structural deformity or trauma to the nasal bones. Tracheostomy and submental intubation have their drawbacks. To overcome these shortcomings we used Percutaneous Dilatational Tracheostomy Kit (PDTK) to modify the technique of submental intubation. Serial dilatations were performed over the guide wire before passing the tracheal tube by submental route, using the PDT kit in four patients. Submental intubation could be achieved in all the four cases with this technique and there were no associated complications. Seldinger's technique is a simple and easy technique with minimal bleeding, imperceptible scar, and more importantly anesthesiologists feel more comfortable because of their familiarity with the Seldinger technique.
气道管理对麻醉医生来说是一项挑战，尤其是在颌面外科手术中。口腔气管导管不合适，因为它会干扰手术视野并妨碍牙合。由于鼻骨结构畸形或创伤，鼻气管插管并不总是可行的。气管切开术和颏下插管都有其缺点。为了克服这些缺点，我们使用经皮扩张气管切开套件（PDTK）来改进颏下插管技术。在通过颏下途径插入气管导管之前，在导丝上进行连续扩张，对4例患者使用了PDT套件。采用该技术，4例患者均成功实现颏下插管，且无相关并发症。塞尔丁格技术是一种简单易行的技术，出血少，疤痕不明显，更重要的是，麻醉医生因熟悉塞尔丁格技术而感觉更舒适。
