Ilper H, Kunz T, Faißt M
Abteilung für Anästhesie, Intensiv‑, Rettungs- und Schmerzmedizin, BG-Klinikum Hamburg, Bergedorfer Str. 10, 21033, Hamburg, Deutschland.
Klinik für Anästhesie, Rettungsmedizin und Schmerztherapie, Helios Dr. Horst Schmidt Kliniken, Wiesbaden, Deutschland.
Anaesthesist. 2020 Jul;69(7):521-532. doi: 10.1007/s00101-020-00792-9.
As a single and reliable parameter for prediction of the difficult airway is missing, the specialist societies for anesthesiology recommend the use of scores that combine the individual parameters. Contemporary scores include head-neck mobility, mouth opening and anatomical distances. Their training and correct performance are essential. For a broad acceptance the performance has to be easy and fast. In addition, before anesthesia a check must be made for pathological alterations (e.g. tumors) in the head and neck region and the patient history must be thoroughly determined. If the patient reports difficulties with securing the airway in the past, these are likely to occur again if they have not been surgically resolved. This includes an accurate documentation of the airway and knowledge of the in-house standard operating procedure on unexpected difficult airways as well as local equipment. Preparation causes work but may save lives.
由于缺少用于预测困难气道的单一可靠参数,麻醉专业协会建议使用综合个体参数的评分系统。当代评分系统包括头颈部活动度、张口度和解剖学距离。对这些评分系统的培训和正确应用至关重要。为了得到广泛认可,其应用必须简便快捷。此外,麻醉前必须检查头颈部区域是否存在病理性改变(如肿瘤),并全面了解患者病史。如果患者既往有气道保障困难的情况,若未通过手术解决,很可能再次发生。这包括对气道进行准确记录,熟悉医院关于意外困难气道的标准操作流程以及当地可用设备。做好准备工作虽需付出努力,但可能挽救生命。