Giraud O, Bourgain J L, Marandas P, Billard V
Department of Anaesthesiology, Institut Gustave ROUSSY, Villejuif, France.
Can J Anaesth. 1997 Dec;44(12):1237-41. doi: 10.1007/BF03012769.
To test the efficacy of the LMA in patients with previous oral or cervical radiotherapy, without upper airway obstruction.
In nine patients after oral or cervical radiotherapy, efficiency of ventilation was assessed after induction of general anaesthesia and LMA insertion. Fibreoptic examination through the tube was performed to check the position of LMA.
In patients who had had oral radiotherapy, all five had limited mouth opening and in two, LMA insertion was difficult but permitted good ventilation. In the four patients who had had cervical radiotherapy, LMA insertion was easy but, in two, the lungs were difficult to ventilate and, in two, the lungs could not be ventilated and orotracheal intubation was required.
In patients with limitation of mouth opening after oral radiotherapy, LMA may represent an alternative to tracheal intubation. In patient with cervical sclerosis after radiotherapy; the use of LMA should be avoided.
测试喉罩在既往接受过口腔或颈部放疗、无上呼吸道梗阻患者中的有效性。
对9例接受过口腔或颈部放疗的患者，在全身麻醉诱导和插入喉罩后评估通气效率。通过喉罩导管进行纤维光学检查以确认喉罩位置。
接受过口腔放疗的患者中，5例均有张口受限，其中2例插入喉罩困难，但通气良好。接受过颈部放疗的4例患者中，喉罩插入容易，但2例肺部通气困难，2例无法通气，需行气管插管。
口腔放疗后张口受限的患者，喉罩可作为气管插管的替代方法。放疗后颈部硬化的患者应避免使用喉罩。
