Light-guided retrograde intubation

被引:16
作者
Hung, OR
AlQatari, M
机构
[1] DALHOUSIE UNIV,DEPT ANAESTHESIA,HALIFAX,NS,CANADA
[2] DALHOUSIE UNIV,DEPT PHARMACOL,HALIFAX,NS B3H 4H7,CANADA
来源
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE | 1997年 / 44卷 / 08期
关键词
D O I
10.1007/BF03013165
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Purpose: Transillumination of the soft tissues using a lightwand (Trachlight(TM)) can guide the endotracheal tube (E-TT) 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. Methods: After obtaining institutional approval and informed consent, 27 patients were studied. Light-guided retrograde intubation was performed either awake, or under general anaesthesia. Following cricothyroid membrane puncture using a # 18 iv catheter, an epidural catheter was advanced cephalad into the oropharynx. While pulling the epidural catheter taut, the ETT; with the Trachlight(TM) in place, was advanced into the glottis. When the tip of the ETT entered the glottis, a bright glow was seen in the anterior neck, The number of attempts, failures, complications, the times required to puncture the cricothyroid membrane, insert the epidural catheter, and insert the E-TT into the trachea were recorded. Results: In all patients, the tracheas were successfully intubated. The mean (+/- sd) time to perform cricothyroid 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 intubating technique was 205.8 +/- 78.3 sec. Apart from minor bleeding at the cricothyroid membrane puncture site, there were no major complications. Conclusion: In 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.
引用
收藏
页码:877 / 882
页数:6
相关论文
共 15 条
  • [1] PULLING VERSUS GUIDING - A MODIFICATION OF RETROGRADE GUIDED INTUBATION
    ABOUMADI, MN
    TROP, D
    [J]. CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 1989, 36 (03): : 336 - 339
  • [2] MODIFICATION OF RETROGRADE GUIDE FOR ENDOTRACHEAL INTUBATION
    BOURKE, D
    LEVESQUE, PR
    [J]. ANESTHESIA AND ANALGESIA, 1974, 53 (06) : 1013 - 1014
  • [3] BUTLER F S, 1960, Anesth Analg, V39, P333
  • [4] SOLVING A DIFFICULT INTUBATION
    CARLSON, CA
    PERKINS, HM
    VELTKAMP, S
    [J]. ANESTHESIOLOGY, 1986, 64 (04) : 537 - 538
  • [5] RETROGRADE INTUBATION - A FACILITATED APPROACH
    DHARA, SS
    [J]. BRITISH JOURNAL OF ANAESTHESIA, 1992, 69 (06) : 631 - 633
  • [6] J-WIRE FACILITATES TRANSLARYNGEAL GUIDED INTUBATION
    GERENSTEIN, RI
    [J]. ANESTHESIOLOGY, 1992, 76 (06) : 1059 - 1059
  • [7] CLINICAL-TRIAL OF A NEW LIGHTWAND DEVICE (TRACHLIGHT) TO INTUBATE THE TRACHEA
    HUNG, OR
    PYTKA, S
    MORRIS, I
    MURPHY, M
    LAUNCELOTT, G
    STEVENS, S
    MACKAY, W
    STEWART, RD
    [J]. ANESTHESIOLOGY, 1995, 83 (03) : 509 - 514
  • [8] LIGHTWAND INTUBATION .2. CLINICAL-TRIAL OF A NEW LIGHTWAND FOR TRACHEAL INTUBATION IN PATIENTS WITH DIFFICULT AIRWAYS
    HUNG, OR
    PYTKA, S
    MORRIS, I
    MURPHY, M
    STEWART, RD
    [J]. CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 1995, 42 (09): : 826 - 830
  • [9] LIGHTWAND INTUBATION .1. A NEW LIGHTWAND DEVICE
    HUNG, OR
    STEWART, RD
    [J]. CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 1995, 42 (09): : 820 - 825
  • [10] OVASSAPIAN A, 1983, ANESTH ANALG, V62, P692