Farag Ehab
Associate Professor of Anesthesiology Cleveland Clinic Lerner College of Medicine Case Western University and Director of Clinical Research Department of General Anesthesia and Outcomes Research, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Best Pract Res Clin Anaesthesiol. 2016 Mar;30(1):13-25. doi: 10.1016/j.bpa.2016.01.001. Epub 2016 Jan 22.
Cervical spine surgery is one of the most commonly performed spine surgeries in the United States, and 90% of the cases are related to degenerative cervical spine disease (the rest to cervical spine trauma and/or instability). The airway management for cervical spine surgery represents a crucial step in the anesthetic management to avoid injury to the cervical cord. The crux for upper airway management for cervical spine surgery is maintaining the neck in a neutral position with minimal neck movement during endotracheal intubation. Therefore, the conventional direct laryngoscopy (DL) can be unsuitable for securing the upper airway in cervical spine surgery, especially in cases of cervical spine instability and myelopathy. This review discusses the most recent evidence-based facts of the main advantages and limitations of different techniques available for upper airway management for cervical spine surgery.
颈椎手术是美国最常开展的脊柱手术之一，其中90%的病例与退行性颈椎疾病相关（其余与颈椎创伤和/或不稳定有关）。颈椎手术的气道管理是麻醉管理中的关键步骤，以避免损伤颈髓。颈椎手术的上气道管理的关键在于在气管插管期间将颈部保持在中立位置，尽量减少颈部活动。因此，传统的直接喉镜检查（DL）可能不适用于颈椎手术中确保上气道安全，尤其是在颈椎不稳定和脊髓病的情况下。本文综述讨论了颈椎手术上气道管理可用的不同技术的主要优点和局限性的最新循证事实。
