Mendel P, Bristow A
Department of Anaesthesia, St. Bartholomew's Hospital, West Smithfield, London.
Anaesthesia. 1993 Mar;48(3):263-5. doi: 10.1111/j.1365-2044.1993.tb06916.x.
Twenty patients undergoing elective procedures on the larynx and pharynx were anaesthetised using a propofol infusion and a bolus of vecuronium. High frequency jet ventilation was employed via a 7 French gauge catheter, with a second catheter being used to measure expired carbon dioxide levels. The Bullard laryngoscope was compared with the Macintosh instrument both for visualising the larynx and subsequently inserting a catheter. One catheter was left in place until the patient was fully awake, and in one case this enabled gas exchange to be maintained in the presence of laryngospasm. Using the Bullard laryngoscope, intubation was possible in all 20 patients, in a mean time of 22 (6.8) s. Using the Macintosh laryngoscope only 16 patients could be intubated and this took significantly longer at 34 (18.3) s (p < 0.05). The Bullard laryngoscope and high frequency jet ventilation offer a reliable method of intubating and anaesthetising patients with upper airways pathology and further benefits may accrue in the recovery period.
二十名接受择期喉和咽手术的患者使用丙泊酚输注和一剂维库溴铵进行麻醉。通过一根7号法式导管进行高频喷射通气，另一根导管用于测量呼出二氧化碳水平。将Bullard喉镜与Macintosh器械在观察喉部以及随后插入导管方面进行了比较。一根导管留置原位直至患者完全清醒，在一例中，这使得在喉痉挛情况下仍能维持气体交换。使用Bullard喉镜，所有20名患者均能成功插管，平均时间为22（6.8）秒。使用Macintosh喉镜时，仅16名患者能够插管，且所需时间明显更长，为34（18.3）秒（p<0.05）。Bullard喉镜和高频喷射通气为患有上气道病变的患者提供了一种可靠的插管和麻醉方法，并且在恢复期可能会带来更多益处。
