Arndt G A, Topp J, Hannah J, McDowell T S, Lesko A
Department of Anesthesiology, University of Wisconsin Medical School, Madison 53792-3272, USA.
Can J Anaesth. 1998 Mar;45(3):257-60. doi: 10.1007/BF03012912.
We report two cases of difficult intubation where a laryngeal mask airway (LMA) was used and changed to a conventional endotracheal tube using a retrograde intubation set.
In two patients, following induction of anaesthesia, the trachea could not be intubated in the conventional fashion with a blade. In both patients an LMA was inserted to achieve an airway. In both patients intubation with a conventional endotracheal tube was required. A Cook Retrograde Intubation Kit and fibreoptic bronchoscope were used to change the LMA to conventional endotracheal tube without problems.
The Cook retrograde intubation allows an LMA to be replaced with an endotracheal tube with an ID greater than 6 mm with a #3 or 7 mm with a #5 LMA. This technique places an exchange stylet into the airway which is superior to a conventional guidewire. This method allows the airway to be maintained until the LMA is exchanged with an endotracheal tube. Anaesthesia may be maintained and the airway instrumented without difficulty using this technique.
我们报告两例困难插管病例，其中使用了喉罩气道（LMA），并使用逆行插管套件将其更换为传统气管内导管。
在两名患者中，麻醉诱导后，无法用喉镜以传统方式进行气管插管。两名患者均插入了喉罩气道以建立气道。两名患者均需要插入传统气管内导管。使用库克逆行插管套件和纤维支气管镜将喉罩气道顺利更换为传统气管内导管。
库克逆行插管法可将内径大于6mm的气管内导管（3号喉罩气道对应）或内径7mm的气管内导管（5号喉罩气道对应）替换喉罩气道。该技术将交换管芯置入气道，优于传统导丝。此方法可维持气道，直至喉罩气道被气管内导管替换。使用该技术可顺利维持麻醉并进行气道操作。
