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双颌手术患者拔管后急性气道梗阻情况下的食管-气管联合导管置入术

Combitube insertion in the situation of acute airway obstruction after extubation in patients underwent two-jaw surgery.

作者信息

Choi Yoon Ji, Park Sookyung, Chi Seong-In, Kim Hyun Jeong, Seo Kwang-Suk

机构信息

Department of Anesthesiology and Pain Medicine, Seoul National University Bungdang Hospital, Seongnam, Korea.

Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Korea.

出版信息

J Dent Anesth Pain Med. 2015 Dec;15(4):235-239. doi: 10.17245/jdapm.2015.15.4.235. Epub 2015 Dec 31.

Abstract

The Combitube is an emergency airway-maintaining device, which can supply oxygen to dyspneic patients in emergency situations following two-jaw surgery. These patients experience difficulty in opening the mouth or have a partially obstructed airway caused by edema or hematoma in the oral cavity. As such, they cannot maintain the normal airway. The use of a Combitube may be favorable compared to the laryngeal mask airway because it is a thin and relatively resilient tube. A healthy 24-year-old man was dyspneic after extubation. Oxygen saturation fell below 90% despite untying the bimaxillary fixation and ambubagging. The opening of the mouth was narrow; thus, emergency airway maintenance was gained by insertion of a Combitube. The following day, a facial computer tomography revealed that the airway space narrowing was severe compared to its pre-operational state. After the swelling subsided, the patient was successfully extubated without complications.

摘要

双腔通气道是一种紧急气道维持装置,可在双颌手术后的紧急情况下为呼吸困难的患者提供氧气。这些患者在开口时会遇到困难,或者由于口腔水肿或血肿导致气道部分阻塞。因此,他们无法维持正常气道。与喉罩气道相比,使用双腔通气道可能更有利,因为它是一种细且相对有弹性的导管。一名24岁健康男性拔管后出现呼吸困难。尽管解开了双颌固定并进行了面罩通气,氧饱和度仍降至90%以下。口腔开口狭窄;因此,通过插入双腔通气道实现了紧急气道维持。第二天,面部计算机断层扫描显示气道空间比术前状态严重变窄。肿胀消退后,患者成功拔管,无并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12bb/5564160/3e8e1b3a3d33/jdapm-15-235-g001.jpg

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