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手术台高度对面罩通气困难程度及喉镜视野的影响

Impact of Operating Table Height on the Difficulty of Mask Ventilation and Laryngoscopic View.

作者信息

Ikeda Tsuyoshi, Miyoshi Hirotsugu, Xia Guo-Qiang, Kido Kenshiro, Sumii Ayako, Watanabe Tomoyuki, Kamiya Satoshi, Narasaki Soshi, Kato Takahiro, Tsutsumi Yasuo M

机构信息

Department of Anesthesiology and Critical Care, Hiroshima University Hospital, Hiroshima 734-8551, Japan.

Department of Anesthesiology and Critical Care, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan.

出版信息

J Clin Med. 2024 Oct 8;13(19):5994. doi: 10.3390/jcm13195994.

Abstract

: Airway management techniques, including mask ventilation and tracheal intubation, are vital across medical settings. However, these procedures can be challenging, especially when environmental conditions are less than ideal. This study explores how the height of the operating table affects the difficulty of anesthesia techniques involving mask ventilation and tracheal intubation. : Twenty anesthesiologists participated in this study. We assessed the difficulty of procedures such as mask ventilation, Macintosh laryngoscopy, and video laryngoscopy using McGRATH and AWS, on a four-level scale. The operating table's height was adjusted at four points: the operator's umbilicus, the inferior margin of the 12th rib, the xiphoid process, and the nipple. : Mask ventilation was easiest at the operating table's height aligned with the inferior margin of the 12th rib. Conversely, direct laryngoscopic exposure was perceived as easier at higher table heights, with nipple height being optimal. The McGRATH laryngoscopy showed consistent difficulty across table heights, whereas the AWS tended to be somewhat more difficult at greater heights. : The optimal bed height for video laryngoscopy coincided with that for mask ventilation. Video laryngoscopy offers enhanced flexibility in optimal patient positioning compared to Macintosh laryngoscopy, contributing to its advantages in tracheal intubation procedures.

摘要

气道管理技术,包括面罩通气和气管插管,在所有医疗环境中都至关重要。然而,这些操作可能具有挑战性,尤其是在环境条件不理想的情况下。本研究探讨手术台高度如何影响涉及面罩通气和气管插管的麻醉技术的难度。

二十名麻醉医生参与了本研究。我们使用麦格拉思喉镜(McGRATH)和气道可视化系统(AWS),在四个等级量表上评估了面罩通气、麦金托什喉镜检查和视频喉镜检查等操作的难度。手术台高度在四个点进行了调整:术者脐部、第12肋下缘、剑突和乳头水平。

在手术台高度与第12肋下缘对齐时,面罩通气最容易。相反,在较高的手术台高度下,直接喉镜暴露更容易,乳头水平高度最为理想。麦格拉思喉镜检查在不同手术台高度下的难度保持一致,而气道可视化系统在较高高度时往往稍难一些。

视频喉镜检查的最佳床高与面罩通气的最佳床高一致。与麦金托什喉镜检查相比,视频喉镜检查在最佳患者体位方面具有更大的灵活性,这有助于其在气管插管操作中的优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4035/11478010/47863f42a192/jcm-13-05994-g001.jpg

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