Light-guided retrograde intubation
Light-guided retrograde intubation
复制标题
光导逆行插管
DOI：
10.1007/bf03013165
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
Mohammad Al
中科院分区：
文献类型：
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作者：
O. Hung;Mohammad Al
目的利用光源（Trachlight™）照射软组织，引导气管内管（ETT）进入声门，方便逆行插管。本研究评估了这种插管技术对颈椎不稳定患者的有效性和安全性。方法经机构批准和知情同意，对27例患者进行研究。在清醒或全身麻醉下进行光引导逆行插管。使用18ivv导管穿刺甲状腺膜后，将硬膜外导管向前插入口咽。在将硬膜外导管拉紧的同时，将放置有Trachlight™的ETT推进到声门。当ETT的尖端进入声门时，在触角颈部可见明亮的辉光。记录尝试次数、失败次数、并发症、穿刺甲状腺膜、插入硬膜外导管、气管内插管次数。结果所有患者气管插管均成功。甲状腺穿刺、硬膜外置管、气管插管的平均（±sd）时间为66.1±56.2。分别为74.0±25.2和72.8±42.5 SEC。光引导逆行插管技术平均总时间为205.8±78.3秒。除甲状腺膜穿刺部位轻微出血外，无重大并发症。结论在少数患者中，我们已经证明了光引导逆行插管治疗颈椎不稳患者是有效和安全的。这种简单和廉价的技术可能被证明是一个有价值的辅助管理困难的气道。
PurposeTransillumination of the soft tissues using a lightwand (Trachlight™) can guide the endotracheal tube (ETT) into the glottis to facilitate the retrograde intubation. This study evaluated the effectiveness and safety of this intubating technique for patients with cervical spine instability.MethodsAfter obtaining institutional approval and informed consent, 27 patients were studied. Light-guided retrograde intubation was performed either awake, or under general anaesthesia. Following cncothyroid membrane puncture using a # 18ivcatheter, an epidural catheter was advanced cephalad into the oropharynx. While pulling the epidural catheter taut, the ETT, with the Trachlight™ in place, was advanced into the glottis. When the tip of the ETT entered the glottis, a bright glow was seen in the antenor neck. The number of attempts, failures, complications, the times required to puncture the cncothyroid membrane, insert the epidural catheter, and insert the ETT into the trachea were recorded.ResultsIn all patients, the tracheas were successfully intubated. The mean (± sd) time to perform cncothyroid puncture, insert the epidural catheter, and place the ETT into the trachea were 66.1 ± 56.2. 74.0 ± 25.2, and 72.8 ± 42.5 sec respectively. The average total-time for this light-guided retrograde mtubating technique was 205.8 ± 78.3 sec. Apart from minor bleeding at the cncothyroid membrane puncture site, there were no major complications.ConclusionIn a small number of patients, we have shown that light-guided retrograde intubation is effective and safe for patients with cervical spine instability. This simple and inexpensive technique may prove to be a valuable adjunct in the management of difficult airways.