Remifentanil/propofol for fiberoptic intubation. A case report

被引：7

作者：

Neidhart G. ^{[1
,3
]}

Kovács A.F. ^{[2
]}

Bremerich D.H. ^{[1
]}

Kessler P. ^{[1
]}

机构：

[1] Klin. Anasthesiologie, I., Johann Wolfgang Goethe-Univ. F., Frankfurt

[2] Klin. Kiefer-/Plastische G., Johann Wolfgang Goethe-Univ. F., Frankfurt

[3] Klin. Anasthesiologie, I., Johann Wolfgang Goethe-Univ. F., 60590 Frankfurt

来源：

Der Anaesthesist | 2000年 / 49卷 / 6期

关键词：

Analgosedation; Capnography; Fiberoptic intubation; Propofol; Remifentanil;

D O I：

10.1007/s001010070093

中图分类号：

学科分类号：

摘要：

We report a case of a 41-years-old woman presenting for revision of a secondary reconstructive procedure using the modified Tagliacozzi upper arm flap after subtotal maxillectomy. Because of the pedicle flap the upper arm was fixed in a pre-facial position and so fiberoptic intubation was required. After routine pre-anesthetic preparations and topical anesthesia of the nares and nasopharynx a CO2 measuring catheter as well as a O2 catheter to ad minister 100% oxygen was inserted deeply into the left naris. At that time, a continous infusion of 0,05 μg/kg/min remifentanil and 2 mg/kg/h propofol was started. After 4 min, fiberoptic intubation was performed through the right hare without any technical difficulties in conscious sedation of the patient. During the entire fiberoptic intubation SaO2 was constant at 100% and capnogram tracings with etCO2 values ranging from 31 to 33 mmHg were displayed on the monitor. At the end of this second surgical procedure with fixed pre-facial upper arm position the patient was uneventfully extubated fully awake. For the time period of fiberoptic intubation the patient had complete amnesia. Conclusion. With the use of nasal capnography and capnometry in addition to simultaneous O2 administration during fiberoptic intubation under extreme conditions excellent analgosedation with propofol and remifentanil could be provided without compromizing our patients' safety. The presented CO2 measuring and O2 administering device represents a simple and cheap expansion of standard anesthetic monitoring during fiberoptic intubation.

引用

页码：523 / 526

页数：3

共 17 条

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