Pollard R J, Lobato E B
Department of Anesthesiology, University of Florida College of Medicine, Gainesville 32610-0254, USA.
Anesth Analg. 1995 Jul;81(1):135-8. doi: 10.1097/00000539-199507000-00027.
To verify a safe location of the endotracheal tube (ETT), palpation of the ETT at the sternal notch is a time-honored technique: After anesthetic induction and confirmation of orotracheal intubation, the patient's head is placed in a neutral position. The ETT is withdrawn or advanced while gentle, repetitive pressure is applied with the fingers at the level of the suprasternal notch. Simultaneously, the pilot balloon is held in the other hand. When the balloon distends from the pressure applied at the notch, the ETT is secured. We tested the efficacy of this technique in men and women who underwent general anesthesia. After the ETT was secured, the distance (in cm) from its tip to the upper incisors, that is, the length of ETT inserted, was measured to confirm its location relative to the carina. The study population consisted of 44 women and 38 men (n = 82) who ranged in age from 16 to 85 yr and in ASA physical status from I to IV. The size of the ETT tube for women ranged from 7.0 to 8.0 and for men, 7.0 to 8.5. Average distance from the tip of the ETT to teeth in women was 20.2 cm (range, 17-23) and in men 21.9 cm (range, 19-25). Average distance to the carina in women was 3 cm (range, 2-5) and in men 3.4 cm (range, 2-6). In this study, palpation of the ETT cuff effectively confirmed ETT location. The technique, which should not be used to verify endotracheal rather than bronchial intubation, should decrease the risk of bronchial intubation or impingement on the carina.
为验证气管内导管（ETT）的安全位置，在胸骨切迹处触诊ETT是一种历史悠久的技术：麻醉诱导并确认经口气管插管后，将患者头部置于中立位。在胸骨上切迹水平用手指施加轻柔、反复的压力，同时撤回或推进ETT。与此同时，用另一只手握住指示球囊。当球囊因切迹处施加的压力而膨胀时，固定ETT。我们在接受全身麻醉的男性和女性中测试了该技术的有效性。固定ETT后，测量其尖端至上门齿的距离（以厘米为单位），即插入的ETT长度，以确认其相对于隆突的位置。研究人群包括44名女性和38名男性（n = 82），年龄在16至85岁之间，美国麻醉医师协会（ASA）身体状况分级为I至IV级。女性ETT导管尺寸范围为7.0至8.0，男性为7.0至8.5。女性ETT尖端至牙齿的平均距离为20.2 cm（范围为17 - 23），男性为21.9 cm（范围为19 - 25）。女性至隆突的平均距离为3 cm（范围为2 - 5），男性为3.4 cm（范围为2 - 6）。在本研究中，触诊ETT套囊可有效确认ETT位置。该技术不应被用于验证气管插管而非支气管插管，应可降低支气管插管或撞击隆突的风险。
