Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA.
Paediatr Anaesth. 2020 Mar;30(3):288-295. doi: 10.1111/pan.13815. Epub 2020 Jan 20.
Shared airway surgery in children is a complex, high-risk undertaking that requires continuous communication and cooperation between the anesthetic and surgical teams. Airway abnormalities commonly seen in children, the surgical options, and the anesthetic techniques that can be used to care for this vulnerable population are discussed. Many of these procedures were traditionally carried out using jet ventilation, or intermittent tracheal intubation, but increasingly spontaneously breathing "tubeless" techniques are being used. This review has been written from both the surgical and anesthetic perspective, highlighting the concerns that both specialties have in relation to the maintenance of surgical access and operating conditions, and the need for the provision of anesthesia, oxygenation, and ventilation where the airway is the primary site of operation.
儿童共用气道手术是一项复杂的高风险手术,需要麻醉和手术团队之间持续的沟通与协作。本文讨论了儿童常见的气道异常、手术选择以及可用于护理这一脆弱人群的麻醉技术。许多此类手术传统上采用射流通气或间歇性气管插管进行,但越来越多的“无管”自主呼吸技术正在得到应用。本文从手术和麻醉的角度进行了综述,强调了两个专业在维持手术通道和手术条件方面的关注点,以及在气道为主要手术部位时提供麻醉、氧合和通气的必要性。