General Practitioner-Anesthesiologist, Sunshine Coast, QLD, Australia.
House Officer, Sunshine Coast, QLD, Australia.
Anesth Prog. 2021 Jun 1;68(2):107-113. doi: 10.2344/anpr-68-02-03.
Nasotracheal intubation remains an underused but invaluable technique for securely managing the airway during oral and maxillofacial surgery. In this article, we present a modified clinical technique that allows for the potential introduction into clinical practice of 2 new airway devices: a nasal laryngeal mask airway and an interchangeable oral/nasal endotracheal tube. We hypothesize that with the use of proper techniques, these devices can add new and safer alternatives for securing an airway by the nasal route. The advantage of this novel technique is that the airway is secured by the oral route prior to performing a modified retrograde nasal intubation, eliminating the danger of profuse epistaxis precipitating a "cannot intubate, cannot ventilate" scenario. In addition, the design and materials used in the components of the devices may minimize trauma. The authors aim to inform clinicians about the indications, physical characteristics, and insertion/removal techniques related to these new devices.
经鼻气管插管仍然是一种未被充分利用但非常有价值的技术，可在口腔颌面外科手术期间安全管理气道。在本文中，我们介绍了一种改良的临床技术，该技术可将两种新的气道设备（鼻喉罩气道和可互换的经口/经鼻气管内管）引入临床实践。我们假设，通过使用适当的技术，这些设备可以通过经鼻途径为气道安全提供新的、更安全的选择。该新技术的优势在于，在进行改良的逆行经鼻插管之前，通过经口途径来固定气道，从而消除大量鼻出血引发“无法插管、无法通气”情况的危险。此外，设备组件中使用的设计和材料可能会最小化创伤。作者旨在向临床医生介绍与这些新设备相关的适应证、物理特性和插入/取出技术。
