Fluoroscope-aided retrograde placement of guide wire for tracheal intubation in patients with limited mouth opening.
Fluoroscope-aided retrograde placement of guide wire for tracheal intubation in patients with limited mouth opening.
复制标题
荧光镜辅助逆行放置导丝用于张口受限患者的气管插管。
DOI：
10.1093/bja/aeh297
复制
发表时间：
2005
影响因子：
9.8
通讯作者：
S. Baniwal
中科院分区：
文献类型：
--
作者：
B. Biswas;Prithwis Bhattacharyya;Sumati Joshi;U. R. Tuladhar;S. Baniwal
通过环甲穿刺将逆行导管/钢丝送入咽部，可以在没有柔性纤维支气管镜或此类设备的专家用户的困难情况下促进气管插管。口腔和/或鼻腔从咽部取出导管/导线时，一定的张口是必不可少的。2例TMJ强直和张口受限的患者需要在全身麻醉下进行TMJ间隙关节成形术。由于我们没有灵活的纤维支气管镜，我们进行了透视辅助鼻腔取材，通过环甲穿刺法向上穿过导丝，随后完成了钢丝引导的鼻气管插管。在没有柔性纤维支气管镜的情况下，这项技术对于张口受限的患者来说是非常有用的插管辅助。
Passing a retrograde catheter/wire into the pharynx through a cricothyroid puncture can facilitate tracheal intubation in difficult situations where either a flexible fibre-optic bronchoscope or an expert user of such a device is not available. Some mouth opening is essential for the oral and/or nasal retrieval of the catheter/wire from the pharynx. Two patients with temporo-mandibular joint (TMJ) ankylosis and extremely limited mouth opening required gap arthroplasty of the TMJ under general anaesthesia. Because we did not have a flexible fibre-optic bronchoscope, we performed fluoroscopy-assisted nasal retrieval of the guide wire passed up through a cricothyroid puncture and subsequently accomplished wire-guided naso-tracheal intubation. In the absence of a flexible fibre-optic bronchoscope, this technique is a very useful aid to intubation in patients with limited mouth opening.