Lee Dowon, Baik Jiseok, Yun Giyoung, Kim Eunsoo
Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea.
World J Clin Cases. 2018 Dec 26;6(16):1189-1193. doi: 10.12998/wjcc.v6.i16.1189.
Fiberoptic bronchoscopic intubation is the gold standard for endotracheal intubation in difficult or compromised airway situations. However, oxygen insufflation through the working channel of a fiberscope is a controversial method because of the possibility of gastric distention and rupture during an awake fiberoptic bronchoscopic intubation, despite the advantages of preventing fogging of the fiberoptic bronchoscopic lens, blowing oral secretions away, and oxygenation of patients.
Here, we describe a case of cervical instability where we rapidly performed fiberoptic bronchoscopic intubation using oxygen insufflation through working channel of the broncoscopy to administer general anesthesia after two previous failures due to low visibility. A 50-year-old man with a non-specific medical history underwent emergency cervical spine surgery for posterior fusion of the C2 and C3 vertebrae. After two unsuccessful attempts at intubation using the fiberoptic broncoscopy, we performed it successfully using the oxygen insufflation the working channel, instead of using suction to remove the secretion from the lens.
Oxygen insufflation the working channel of the broncoscopy is a useful method for assisting with difficult intubation cases.
在困难气道或气道受损的情况下，纤维支气管镜引导插管是气管插管的金标准。然而，通过纤维支气管镜工作通道进行氧气吹入是一种存在争议的方法，因为在清醒纤维支气管镜引导插管过程中存在胃扩张和破裂的可能性，尽管它具有防止纤维支气管镜镜头起雾、吹出口腔分泌物以及为患者供氧等优点。
在此，我们描述一例颈椎不稳的病例，在先前因视野不佳导致两次插管失败后，我们通过支气管镜工作通道进行氧气吹入，快速实施了纤维支气管镜引导插管以实施全身麻醉。一名有非特异性病史的50岁男性因C2和C3椎体后路融合接受急诊颈椎手术。在使用纤维支气管镜进行两次插管尝试失败后，我们通过向工作通道吹入氧气而非使用吸引器清除镜头上的分泌物，成功完成了插管。
通过支气管镜工作通道吹入氧气是辅助困难插管病例的一种有用方法。
