Tsay Pei-Jiuan, Yang Chih-Pin, Luk Hsiang-Ning, Qu Jason Zhensheng, Shikani Alan
Department of Anesthesia, Hualien Tzuchi Hospital, Hualien 97002, Taiwan.
Bio-Math Laboratory, Department of Financial Engineering, Providence University, Taichung 43301, Taiwan.
Healthcare (Basel). 2022 Apr 15;10(4):741. doi: 10.3390/healthcare10040741.
Induction of anesthesia can be challenging for patients with difficult airways and head or neck tumors. Factors that could complicate airway management include poor dentition, limited mouth opening, restricted neck motility, narrowing of oral airway space, restricted laryngeal and pharyngeal space, and obstruction of glottic regions from the tumor. Current difficult airway management guidelines include awake tracheal intubation, anesthetized tracheal intubation, or combined awake and anesthetized intubation. Video laryngoscopy is often chosen over direct laryngoscopy in patients with difficult airways because of an improved laryngeal view, higher frequency of successful intubations, higher frequency of first-attempt intubation, and fewer intubation attempts. In this case series report, we describe the video-assisted intubating stylet technique in five patients with difficult airways. We believe that the intubating stylet is a feasible and safe airway technique for anesthetized tracheal intubation in patients with an anticipated difficult airway.
对于气道困难以及患有头颈部肿瘤的患者而言,麻醉诱导可能具有挑战性。可能使气道管理复杂化的因素包括牙列不佳、张口受限、颈部活动受限、口腔气道空间变窄、喉和咽腔空间受限以及肿瘤导致声门区域梗阻。当前的困难气道管理指南包括清醒气管插管、麻醉下气管插管或清醒与麻醉相结合的插管方式。由于喉镜视野改善、插管成功率更高、首次尝试插管频率更高以及插管尝试次数更少,在气道困难的患者中,视频喉镜检查通常比直接喉镜检查更常被选用。在本病例系列报告中,我们描述了5例气道困难患者的视频辅助插管探条技术。我们认为,对于预期气道困难的患者,插管探条是一种用于麻醉下气管插管的可行且安全的气道技术。