Miyazaki Yu, Komasawa Nobuyasu, Omoto Haruka, Miyazaki Shinichiro, Kido Haruki, Minami Toshiaki
Masui. 2014 Jun;63(6):668-70.
We report the successful awake tracheal intubation in a patient with hypopharyngeal cancer and gastroesophageal regurgitation with the TaperGuard Evac tracheal tube (TaperGuard) and Pentax-AWS Airwayscope (AWS). A 63-year-old man with hypopharyngeal cancer with invasion to the glottis was scheduled for total laryngectomy under general anesthesia. He had undergone thoracic esophagectomy and could not maintain supine position due to severe gastroesophageal regurgitation. To avoid vomiting after induction of anesthesia, we planned awake intubation in the sitting position with the AWS. After topical anesthesia with 8% lidocaine and infusion of fentanyl and continuous dexmedetomidine, the AWS was inserted into his mouth in the sitting position from the cranial side. The AWS allowed visualizing the glottis avoiding the cancer, leading to safe placement of the tracheal tube.
我们报告了一例下咽癌合并胃食管反流患者使用TaperGuard Evac气管导管（TaperGuard）和宾得AWS可视喉镜（AWS）成功实施清醒气管插管的病例。一名63岁患有侵犯声门的下咽癌男性患者计划在全身麻醉下进行全喉切除术。他曾接受过胸段食管癌切除术，由于严重的胃食管反流无法保持仰卧位。为避免麻醉诱导后呕吐，我们计划使用AWS在坐位下进行清醒插管。在使用8%利多卡因局部麻醉并输注芬太尼和持续输注右美托咪定后，在坐位下从头部方向将AWS插入其口腔。AWS能够在避开肿瘤的情况下看到声门，从而安全地插入气管导管。
