Ouchi Kentaro, Sugiyama Kazuna
Department of Dental Anesthesiology, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
Department of Dental Anesthesiology, Field of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University Graduate School, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
J Anesth. 2016 Apr;30(2):193-8. doi: 10.1007/s00540-015-2110-0. Epub 2015 Nov 30.
Incorrect endobronchial placement of the tracheal tube can lead to serious complications. Hence, it is necessary to determine the accuracy of tracheal tube positioning. Markers are included on tracheal tubes, in the process of their manufacture, as indicators of approximate intubation depth. In addition, continuous chest auscultation has been used for determining the proper position of the tube. We examined insertion depth using the cuff depth and continuous chest auscultation method (CC method), compared with insertion depth determined by the marker method, to assess the accuracy of these methods.
After induction of anesthesia, tracheal intubation was performed in each patient. In the CC method, the depth of tube insertion was measured when the cuff had passed through the glottis, and again when breath sounds changed in quality; the depth of tube insertion was determined from these values. In the marker method, the depth of tube insertion was measured and determined when the marker of the tube had reached the glottis, using insertion depth according to the marker as an index.
Insertion depth by the marker method was 26.6 ± 1.2 cm and by the CC method was 28.0 ± 1.2 cm (P < 0.0001). The CC method indicated a significantly greater depth than the marker method.
This study determined the safe range of tracheal tube placement. Tube positions determined by the CC method were about 1 cm deeper than those determined by the marker. This information is important to prevent accidental one-lung ventilation and accidental extubation.
UMIN No. UMIN000011375.
气管导管支气管内放置错误可导致严重并发症。因此，有必要确定气管导管定位的准确性。气管导管在制造过程中包含标记，作为大致插管深度的指标。此外，持续胸部听诊已用于确定导管的正确位置。我们使用气囊深度和持续胸部听诊法（CC法）检查插管深度，并与标记法确定的插管深度进行比较，以评估这些方法的准确性。
麻醉诱导后，对每位患者进行气管插管。在CC法中，当气囊通过声门时测量导管插入深度，当呼吸音质量改变时再次测量；根据这些值确定导管插入深度。在标记法中，当导管标记到达声门时测量并确定导管插入深度，以根据标记的插入深度为指标。
标记法的插入深度为26.6±1.2cm，CC法为28.0±1.2cm（P<0.0001）。CC法显示的深度明显大于标记法。
本研究确定了气管导管放置的安全范围。CC法确定的导管位置比标记法深约1cm。这些信息对于预防意外单肺通气和意外拔管很重要。
UMIN编号UMIN000011375。
