Saini Suman, Singhal Swati, Prakash Smita
Department of Anesthesiology and Critical Care, VMMC and Safdarjung Hospital, New Delhi, India.
J Anaesthesiol Clin Pharmacol. 2021 Jul-Sep;37(3):319-327. doi: 10.4103/joacp.JOACP_315_19. Epub 2021 Oct 12.
Airway management of patients with maxillofacial trauma remains a challenging task for an anesthesiologist in the emergency and perioperative settings due to anatomical distortion. Detailed knowledge of maxillofacial and airway anatomy is desired for the correct diagnosis of extent and severity of the injury. Basic principles of advanced trauma life support protocols should be followed while managing such patients. Establishing unobstructed airway remains the top priority while maintaining C-spine immobilization and preventing aspiration. Although multiple options exist for securing the airway, a universal technique of airway management may not be applicable to all the patients. Hence, a high index of suspicion along with timely and skillful management is warranted. In this brief review, issues affecting the airway management in cases of maxillofacial trauma are addressed with the possible uses of a wide range of airway management devices available in emergency and elective scenarios.
由于解剖结构变形,在急诊和围手术期环境中,颌面创伤患者的气道管理对麻醉医生来说仍然是一项具有挑战性的任务。需要详细了解颌面和气道解剖结构,以正确诊断损伤的范围和严重程度。在处理此类患者时,应遵循高级创伤生命支持方案的基本原则。在保持颈椎固定和防止误吸的同时,建立通畅的气道仍然是首要任务。尽管确保气道安全有多种选择,但通用的气道管理技术可能并不适用于所有患者。因此,需要高度的怀疑指数以及及时和熟练的管理。在这篇简短的综述中,我们讨论了影响颌面创伤病例气道管理的问题,以及在急诊和择期情况下可用的各种气道管理设备的可能用途。