Yao Keiko, Goto Kinuko, Nishimura Akiko, Shimazu Reina, Tachikawa Satoshi, Iijima Takehiko
Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan.
Anesth Prog. 2019 Spring;66(1):8-13. doi: 10.2344/anpr-65-04-04.
An estimation of the appropriate tubing depth for fixation is helpful to prevent inadvertent endobronchial intubation and prolapse of cuff from the vocal cord. A feasible estimation formula should be established. We measured the anatomical length of the upper-airway tract through the oral and nasal pathways on cephalometric radiographs and tried to establish the estimation formula from the height of the patient. The oral upper-airway tract was measured from the tip of the incisor to the vocal cord. The nasal upper-airway tract was measured from the tip of the nostril to the vocal cord. The tracts were smoothly traced by using software. The length of the oral upper-airway tract was 13.2 ± 0.8 cm, and the nasal upper-airway tract was 16.1 ± 0.9 cm. We found no gender difference ( p > .05). The correlations between the patients' height and the length of the oral and nasal upper-airway tracts were 0.692 and 0.760, respectively. We found that the formulas (height/10) - 3 (in cm) for oral upper-airway and (height/10) + 1 (in cm) for nasal upper-airway tract are the simple fit estimation formulas. The average error and standard deviation of the estimated values from the measured values were 0.50 ± 0.66 cm for the oral tract and 0.39 ± 0.63 cm for the nasal tract. Thus, considering the length of the intubation marker of each product (DM), we would like to propose the length of tube fixation as (height/10) + 1 + DM for nasal intubation and (height/10) - 3 + DM for oral intubation. In conclusion, the estimation formulas of (height/10) - 3 + DM and (height/10) + 1 + DM for oral and nasal intubation, respectively, are within almost 1 cm error in most cases.
估计合适的固定导管深度有助于防止意外的支气管内插管和套囊从声带脱垂。应建立一个可行的估计公式。我们在头颅侧位片上测量了经口腔和鼻腔途径的上呼吸道解剖长度，并试图根据患者身高建立估计公式。口腔上呼吸道从门牙尖端测量至声带。鼻腔上呼吸道从鼻孔尖端测量至声带。使用软件平滑追踪这些通道。口腔上呼吸道长度为13.2±0.8厘米，鼻腔上呼吸道长度为16.1±0.9厘米。我们未发现性别差异（p>.05）。患者身高与口腔和鼻腔上呼吸道长度的相关性分别为0.692和0.760。我们发现口腔上呼吸道的公式（身高/10）-3（厘米）和鼻腔上呼吸道的公式（身高/10）+1（厘米）是简单合适的估计公式。估计值与测量值的平均误差和标准差，口腔通道为0.50±0.66厘米，鼻腔通道为0.39±0.63厘米。因此，考虑到每种产品的插管标记长度（DM），我们建议鼻插管时导管固定长度为（身高/10）+1+DM，口腔插管时为（身高/10）-3+DM。总之，口腔和鼻插管的估计公式分别为（身高/10）-3+DM和（身高/10）+1+DM，在大多数情况下误差几乎在1厘米以内。
