• Title/Summary/Keyword: Difficult intubation

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기도 유지가 어려운 정신지체 환자에서 후두마스크 삽입 하 치과치료 (USE OF LARYNGEAL MASK AIRWAY (LMA) FOR DENTAL TREATMENT IN MENTALLY RETARD PATIENT WITH DIFFICULT AIRWAY -A CASE REPORT-)

  • 이영은;서광석;김현정;신터전
    • 대한장애인치과학회지
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    • 제4권2호
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    • pp.88-91
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    • 2008
  • A female patient (14 years-old) with mental retardation was scheduled for ambulatory general anesthesia to treat peri-apical abscess and multiple dental caries. She had got cleft palate plasty at 5 years, but there was no past history of difficulty airway during general anesthesia or airway obstruction. Following induction of anesthesia using an inhalational anesthetic technique, conventional naso-tracheal intubation was tried. However, with conventional intubation technique we could not insert tube. And following several trial of intubation with laryngoscope, she developed an upper airway obstruction. Her lungs could not be ventilated using a facial mask and oxygen saturation was decreased. A #3 laryngeal mask airway (LMA) was inserted immediately, which allowed us to ventilate her lungs and restore the oxygen saturation. And dental treatment was carried out under LMA insertion successfully.

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A simple method of intraoperative intubation tube change

  • Cho, Jin Yong;Kim, Hyeon Min;Ryu, Jae Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제40권5호
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    • pp.250-252
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    • 2014
  • Nasotracheal intubation should be performed in patients with jaw fractures because maxillomandibular fixation is required. However, when there are concomitant fractures of the nose and facial bones, an intubation tube positioned at the nose makes it difficult to perform an intricate surgery. In order to overcome these problems, a variety of ways to change the position of the tube have been introduced. We describe a simple technique of switching the tube from a nasal to oral position, which was easily executed in a patient with concomitant nasal and mandibular fractures, accompanied by a literature review.

후두 마스크를 이용한 전신 마취 후 발생된 흡인성 폐렴 (Aspiration Pneumonia after General Anesthesia Using Laryngeal Mask Airway -A case report-)

  • 이덕희;박기호
    • Journal of Yeungnam Medical Science
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    • 제21권1호
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    • pp.127-131
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    • 2004
  • A laryngeal mask airway (LMA) has many advantages in the management of airway emergencies or the treatment of patients in whom intubation is difficult, but the use of LMA during positive ventilation may seem inappropriate to protect the airway because of the risk of pulmonary aspiration of regurgitated gastric contents. We experienced aspiration pneumonia after general anesthesia using LMA in patient who suffered from panperitonitis. It is considered that the main reason for aspiration pneumonia was a leakage of gastric content through the space surrounding the nasogastric tube while under high airway inflation pressure. We concluded that when LMA or the Proseal laryngeal mask airway (PLMA) is chosen for the use in difficult intubations, careful patient-suitability selection and the correct knowledge of LMA and PLMA are needed to protect the airway against aspiration.

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이송 중 기관내 삽관의 효율성 비교 - SALT를 이용한 시뮬레이션 연구 - (Comparison of Endotracheal Intubation to Transfer - A Study of Simulation Using the SALT -)

  • 윤성우;정준호;이효주;최미영
    • 한국정보통신학회:학술대회논문집
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    • 한국정보통신학회 2022년도 추계학술대회
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    • pp.300-302
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    • 2022
  • 이 연구는 성무위기도기 인후두 튜브(SALT)와 직접 후두경을 사용하여 이동중 기관내 삽관의 신속성과 자신감, 용이성 등을 비교하여 전문 기도 관리 시행능력을 향상 시키는데 있다. 연구대상은 J도 소방서에서 근무하고 있는 1급 응급구조사 30명을 대상으로 무작위 교차방법(Randomized crossover design)으로 디자인한 실험연구로 자료 분석은 SPSS 20.0 Version을 사용하였다. 어려운 자세에서 SALT를 이용한 기관내삽관은 직접 후두경을 이용한 기관내삽관 보다 신속성에서 유의한 차이를 보였으며(p<.001), 자신감과 용이성에서도 유의한 차이를 나타냈다(p<.001). 직접 후두경을 사용한 기관내삽관이 어려운 환경이나 이동시 SALT를 이용한다면 안전하고 신속한 삽관을 할 수 있을 것이다.

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Successful difficult airway management using GlideScope video laryngoscope in a child with Cornelia de Lange Syndrome

  • Park, Sang-Jin;Choi, Eun Kyung;Park, Suyong;Bae, Kunjin;Lee, Deokhee
    • Journal of Yeungnam Medical Science
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    • 제35권2호
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    • pp.219-221
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    • 2018
  • Management of airway in a child with Cornelia de Lange Syndrome (CdLS) should be given due consideration because most of them have the problems related to difficult airway. The GlideScope video laryngoscope can be attempted during routine intubation, however it is mostly used in case of difficulty. With adequate preoperative airway assessment, we used the pediatric video laryngoscope as useful alternative airway device in a child with CdLS and orotracheal intubation proceeded uneventfully.

기도 폐쇄로 인한 삽관불능이 갑상선 암환자엣 심장폐우회 마취에 의한 치험 2예 (Two cases of femorofemoral cardiopulmonary bypass prior to induction of anaesthesia in the management of tracheal obstruction by thyroid cancer)

  • 왕수건;김기태;이병주;권재영;김영대;이강대
    • 대한기관식도과학회지
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    • 제9권1호
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    • pp.101-104
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    • 2003
  • One of major problem in endotracheal intubation for general anesthesia is intrathoracic tracheal obstruction induced by tumor such as, intrathoracic goiter and malignant lymphoma etc. Small amount of secretion or hemorrhage and mild tracheal edema may cause aggravation of tracheal obstruction during endotracheal intubation. Also, it is too difficult to perform the emergency tracheostomy in middle tracheal obstruction. We tried to perform femorofemoral cardiopulmonary bypass without endotracheal intubation for induction of general anesthesia in case of middle tracheal obstruction and We reported with review of literature.

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Dexamethasone treatment for bilateral lingual nerve injury following orotracheal intubation

  • Kim, Saeyoung;Chung, Seung-Yeon;Youn, Si-Jeong;Jeon, Younghoon
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제18권2호
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    • pp.115-117
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    • 2018
  • Lingual nerve injury is a rare complication of general anesthesia. The causes of lingual nerve injury following general anesthesia are multifactorial; possible mechanisms may include difficult laryngoscopy, prolonged anterior mandibular displacement, improper placement of the oropharyngeal airway, macroglossia and tongue compression. In this report, we have described a case of bilateral lingual nerve injury that was associated with orotracheal intubation for open reduction and internal fixation of the left distal radius fracture in a 61-year-old woman. In this case, early treatment with dexamethasone effectively aided the recovery of the injured lingual nerve.

Anesthetic management of a large mandibular odontogenic myxoma in a child - a case report

  • Koovakattil Akhil Kuttan;Sri Rama Ananta Nagabhushanam Padala;Anagha P Vina;Kuruba Aravind;Molli Kiran
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제24권3호
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    • pp.213-217
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    • 2024
  • Numerous neoplastic lesions can arise in the orofacial region in the pediatric populations. Odontogenic tumors typically affect the mandible more than the maxilla. Airway management can be challenging in pediatric oral tumors because of the distorted anatomy and physiological variations. Conventional awake fiberoptic intubation is not always possible owing to limited cooperation from the pediatric populations. Herein, we report the case of a 1-year-old child with odontogenic myxoma of the mandible and an anticipated difficult airway. Given the expected difficulties in the airway, video laryngoscope-assisted orotracheal intubation under general anesthesia with maintenance of spontaneous breathing was scheduled. Proper planning and thorough examinations are vital for successful airway management in pediatric patients.

119구급대의 어려운 기관내삽관 교육 전·후 비교 (Comparison of Educational Effects of Difficult Endotracheal Intubation in the 119 Rescue Service)

  • 윤형완;유은영;윤영현
    • 한국콘텐츠학회논문지
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    • 제11권1호
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    • pp.254-265
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    • 2011
  • 본 연구는 J도 소방안전본부 산하 119구급대 60명을 대상으로 하였으며, 연구 기간은 2009년 12월 1일 부터 2월 10일까지였다. 어려운 기관내삽관 교육 전.후 비교 및 일반적 특성에 따른 지식, 자신감, 학업적 자기효능감, 술기수행 능력을 SPSS 14.0을 이용하여 분석한 결과는 다음과 같다. 1. 지식, 자신감, 학업적 자기효능감, 술기수행 능력 모두 교육 전보다 교육 후 유의미하게 증가하였다. 2. 일반적 특성에 따른 교육 전 후 지식은 성별과 병원근무경력에서 모두 유의한 차이를 보였고, 자신감은 계급과 병원경력에서 모두 유의한 차이를 보였다. 학업적 자기효능감은 계급과 병원경력 및 학력에서 모두 유의한 차이를 보였다. 술기수행 능력은 유형 1에서 119구급대 근무경력, 유형 2에서는 대원의 연령과 최종학력이 유의한 차이를 보였으며, 유형 3은 119구급대 근무경력과, 병원에서 근무경력이 교육 후 유의한 차이를 보였다. 유형 4는 연령과 계급에서 교육 전 후 유의한 차이를 보였다. 결론적으로, 119구급대의 기도유지술에 관심을 갖고, 정확한 기관내삽관을 배울 수 있도록 자신감을 함양시킬 수 있는 교육 프로그램이 절실히 필요하다고 사료된다.

Awake fiberoptic nasotracheal intubation for patients with difficult airway

  • Tsukamoto, Masanori;Hitosugi, Takashi;Yokoyama, Takeshi
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제18권5호
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    • pp.301-304
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    • 2018
  • Awake fiberoptic nasotracheal intubation is a useful technique, especially in patients with airway obstruction. It must not only provide sufficient anesthesia, but also maintain spontaneous breathing. We introduce a method to achieve this using a small dose of fentanyl and midazolam in combination with topical anesthesia. The cases of 2 patients (1 male, 1 female) who underwent oral maxillofacial surgery are reported. They received $50{\mu}g$ of fentanyl 2-3 times (total $2.2-2.3{\mu}g/kg$) at intervals of approximately 2 min. Oxygen was administered via a mask at 6 L/min, and 0.5 mg of midazolam was administered 1-4 times (total 0.02-0.05 mg/kg) at intervals of approximately 2 min. A tracheal tube was inserted through the nasal cavity after topical anesthesia was applied to the epiglottis, vocal cords, and into the trachea through the fiberscope channel. All patients were successfully intubated. This is a useful and safe method for awake fiberoptic nasotracheal intubation.