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[用于逆行插管的改良沃特斯技术。关于一例困难插管病例]

[Modified technique of Waters for retrograde intubation. Apropos of a case of difficult intubation].

作者信息

Runti G, Vicenti E, Casseler F, Clarich G

机构信息

Servizio Anestesia e Rianimazione, Istituto per 1' Infanzia, Burlo Garofalo, Trieste, Italia.

出版信息

Cah Anesthesiol. 1996;44(2):145-7.

PMID:8760639
Abstract

The authors describe a case of impossible intubation by classical means in an obese 37-yr old woman, affected with encephalopathy, hydrocephalus and severe psychomotor retardation. After failure of intubation by classical methods using a flexible introducer, the patient was intubated by Waters retrograde technique using an epidural catheter passed through the thyrocricoid membrane and recovered in the mouth. Following this guide the endotracheal tube passed the glottis fairly easily with the help of a flexible "mouse tail-ended" introducer (C-Mettro, Cook, 19.0.80) inserted into the same tube to facilitate alignment of distal tube and trachea. The authors conclude that the combination of epidural catheter and flexible introducer may facilitate the retrograde technique performance; they consider this technique to be an interesting alternative when endotracheal intubation is difficult or impossible by usual methods.

摘要

作者描述了一名37岁肥胖女性的病例,该女性患有脑病、脑积水和严重精神运动发育迟缓,采用传统方法无法进行气管插管。在使用可弯曲引导器经传统方法插管失败后,采用沃特斯逆行技术,通过经环甲膜插入的硬膜外导管对患者进行插管,并在口腔中回收。按照这个引导,借助插入同一导管的可弯曲“鼠尾端”引导器(C-Mettro,库克公司,19.0.80),气管导管相当容易地通过声门,以利于远端导管与气管对齐。作者得出结论,硬膜外导管和可弯曲引导器的组合可能有助于逆行技术的实施;他们认为,当常规方法难以或无法进行气管插管时,这种技术是一种有趣的替代方法。

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