Department of Anesthesiology & Pain Medicine, Soonchunhyang University Hospital Bucheon, Bucheon, Republic of Korea.
J Int Med Res. 2020 Jun;48(6):300060520927875. doi: 10.1177/0300060520927875.
Airway management under anesthesia is given special attention in patients who have large goiters. Nasogastric tube insertion may be difficult in intubated patients with large goiters. Several methods have been proposed to facilitate the insertion of nasogastric tubes in patients with endotracheal intubation; however, a standard insertion method has not been established. A 33-year-old man was admitted to our otolaryngology department for right thyroid lobectomy to remove a larger goiter. A thyroid computed tomography scan revealed a huge cystic mass with tracheal displacement. Although difficult intubation was expected, endotracheal intubation was performed successfully. An anesthesiologist attempted nasogastric tube insertion via the right nostril; however, this was not successful. Next, an angiography catheter was placed in a nasogastric tube, and the nasogastric tube was gently inserted with the patient's neck in mild flexion. This attempt also failed. Finally, the nasogastric tube was gently inserted via anterior displacement of the cricoid cartilage. The nasogastric tube advanced up to 60 cm. Surgery was performed, and the patient was discharged with no complications on postoperative day 8.
在麻醉下进行气道管理时，特别关注有大甲状腺肿的患者。对于有大甲状腺肿的气管插管患者，插入鼻胃管可能很困难。已经提出了几种方法来帮助在气管插管的患者中插入鼻胃管，但尚未建立标准的插入方法。
一名 33 岁男性因右侧甲状腺叶切除术以切除更大的甲状腺肿而被收入耳鼻喉科。甲状腺计算机断层扫描显示巨大的囊性肿块伴有气管移位。尽管预计会出现困难插管，但仍成功进行了气管插管。麻醉师试图通过右鼻孔插入鼻胃管，但没有成功。接下来，将血管造影导管放入鼻胃管中，并使患者颈部轻度弯曲轻轻插入鼻胃管。这次尝试也失败了。最后，通过环状软骨的前移位轻轻插入鼻胃管。鼻胃管推进至 60cm。进行了手术，患者在术后第 8 天出院，没有并发症。
