Hakala P, Randell T, Meretoja O A, Rintala R
Department of Anaesthesia, University of Helsinki, Töölö Hospital, Finland.
Paediatr Anaesth. 1997;7(5):371-4. doi: 10.1046/j.1460-9592.1997.d01-105.x.
Orotracheal fibreoptic intubation under general anaesthesia in children was studied in eleven consecutive patients of three months to eight-years-of-age without anticipated intubation difficulties. One case report is also included. Three fibrescopes with a different diameter were used in the study. The fibrescope used was chosen so that it fitted snugly in the tracheal tube. The fibreoscopy was prolonged in one patient due to mucus and two tries were needed. Resistance to the tracheal tube upon intubation was encountered in five patients, only one of these patients was older than two years. Fibreoptic intubation succeeded in nine patients. Two patients were intubated with the Macintosh laryngoscope. The problems encountered in children during orotracheal fibreoptic intubation under general anaesthesia are the same as with adults: easy fibreoscopy is not always followed by easy tracheal intubation, there may be prolonged fibreoscopy and failed intubations. Manipulation of the tracheal tube can lead to successful tracheal intubation and resistance to the tube is more common in smaller children.
对11例年龄在3个月至8岁、预计无插管困难的儿童在全身麻醉下进行经口气管纤维支气管镜插管术进行了研究。还纳入了1例病例报告。研究中使用了3种不同直径的纤维支气管镜。所使用的纤维支气管镜的选择应使其能紧密地适配气管导管。1例患者因黏液导致纤维支气管镜检查时间延长,需要尝试2次。5例患者在插管时遇到气管导管阻力,其中只有1例患者年龄超过2岁。9例患者纤维支气管镜插管成功。2例患者用麦金托什喉镜插管。儿童在全身麻醉下经口气管纤维支气管镜插管时遇到的问题与成人相同:纤维支气管镜检查顺利并不总是意味着气管插管容易,可能会出现纤维支气管镜检查时间延长和插管失败的情况。气管导管的操作可导致气管插管成功,较小儿童中对导管的阻力更为常见。