鼻咽頭チューブと気管支ファイバースコープで挿管した小下顎症の挿管困難症例

DOI 被引用文献3件 参考文献15件

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  • Fiberoptoic Nasotracheal Intubation for Mandibular Micrognathia with the Aid of Nasopharyngeal Tube: A Case Report.

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We anesthetized a 6-yaer-old boy with mandibular micrognathia and microstomia undergoing surgical implantaion of Hoffman mini-expanders. Retrograde intubation and inser-tion of a laryngeal mask was impossible because of trismus and microstomia. Couscious intubation was also difficult because of the patient's age. Accordingly, we selected fiber-optoic nasotracheal intubation under inhaled anesthesia with a nasopharygeal tube. After premedication with intramuscular scopolamine, anesthesia was induced with intravenous midazolam and ketamine. Care was taken not to depress the patient's spontaneous ventilation. After an adequate topical anesthesia of the nasopharyngeal area, a nasal airway was inserted into the right nostril. Then, the patient was administered 50% nitrous oxide, 3% sevoflurane and oxygen by inhalation via the airway. After attaining an adequate depth of anesthesia, a transtracheal topical anesthesia in the larynx and the trachea was performed. Fiberoptoic nasotracheal intubation through the left nostril was completed readily and safely with this method.

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