Sanuki Takuro, Watanabe Toshihiro, Ozaki Yu, Tachi Mizuki, Kiriishi Kensuke, Mishima Gaku, Kawai Mari, Okayasu Ichiro, Kurata Shinji, Ayuse Takao
Department of Clinical Physiology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
Anesth Prog. 2014 Winter;61(4):169-70. doi: 10.2344/0003-3006-61.4.169.
Mask ventilation, along with tracheal intubation, is one of the most basic skills for managing an airway during anesthesia. Facial anomalies are a common cause of difficult mask ventilation, although numerous other factors have been reported. The long and narrow mandible is a commonly encountered mandibular anomaly. In patients with a long and narrow mandible, the gaps between the corners of the mouth and the lower corners of the mask are likely to prevent an adequate seal and a gas leak may occur. When we administer general anesthesia for these patients, we sometimes try to seal the airway using several sizes and shapes of commercially available face masks. We have found that the management of the airway for patients with certain facial anomalies may be accomplished by attaching a mask upside down.
面罩通气与气管插管一样，是麻醉期间气道管理最基本的技能之一。面部畸形是面罩通气困难的常见原因，尽管还报道了许多其他因素。长而窄的下颌骨是常见的下颌骨畸形。对于长而窄下颌骨的患者，嘴角与面罩下角之间的间隙可能会妨碍形成足够的密封，从而可能发生气体泄漏。当我们为这些患者实施全身麻醉时，有时会尝试使用几种不同尺寸和形状的市售面罩来密封气道。我们发现，对于某些面部畸形的患者，将面罩倒置使用可能有助于气道管理。
