Sugiyama K, Yokoyama K
Department of Anesthesia, Kagoshima University Dental Hospital, Japan.
Anesth Analg. 1996 Feb;82(2):251-3. doi: 10.1097/00000539-199602000-00006.
Displacement of the endotracheal tube (ETT) caused by flexion and extension of the neck and the placement of a tongue depressor was investigated in 10 small children between the ages of 16 and 19 mo by means of a fiberoptic bronchoscope. The ETT tip moved a mean distance of 0.9 cm toward the carina with flexion and 1.7 cm toward the vocal cords with extension of the neck. After the placement of a tongue depressor, the ETT tip, which had once moved toward the vocal cords with neck extension, was displaced a mean distance of 1.2 cm toward the carina. Our results demonstrate that endobronchial intubation and accidental extubation could occur after significant changes of the head position and careless placement of a tongue depressor in small children.
通过纤维支气管镜对10名年龄在16至19个月的幼儿进行研究，观察颈部屈伸和放置压舌板时气管内导管（ETT）的移位情况。颈部屈曲时，ETT尖端平均向隆突移动0.9厘米；颈部伸展时，平均向声带移动1.7厘米。放置压舌板后，原本在颈部伸展时已向声带移位的ETT尖端，平均又向隆突移位1.2厘米。我们的研究结果表明，幼儿头部位置发生显著变化以及压舌板放置不当可能导致支气管内插管和意外拔管。
