[Fiberoptic intubation in adult patients with predictive signs of difficult intubation: inhalational induction using sevoflurane and an endoscopic facial mask].
| Autor: | Favier JC; Service de réanimation polyvalente, département d'anesthésie-réanimation-urgences, HIA Legouest, BP10, 57998, Metz-Armée, France. legouest.daru@dial.oleane.com |
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| Jazyk: | francouzština |
| Zdroj: | Annales francaises d'anesthesie et de reanimation [Ann Fr Anesth Reanim] 2003 Feb; Vol. 22 (2), pp. 96-102. |
| DOI: | 10.1016/s0750-7658(02)00858-4 |
| Abstrakt: | Objective: To evaluate the combination of inhalational induction with sevoflurane and fiberoptic intubation through a specific facial mask for anticipated difficult tracheal intubation (DI) in adults. Study Design: Prospective study. Patients and Methods: Eighteen consecutive patients at risk of DI. After premedication made of hydroxyzine 2 mg x kg(-1), preoxygenation, 0.1 microg x kg(-1) sufentanil was administered (T0), then, inhalational induction was started: sevoflurane 8% in 100% O2 l x min(-1). After 1 min, sevoflurane was decreased to 5% and, if necessary, adapted to obtain an adequate depth of anaesthesia (Ramsay score > 3). Fiberoptic bronchoscopy was performed through a Fibroxy mask. BP was measured every 2.5 min, HR, SpO2, RR were recorded. The results were analyzed by Newman-Keuls test. Results: Intubation was easily realized but it was necessary to assist ventilation in patients presenting prolonged apnea lasting more than 30 s (5 out of 9 patients who presented apnea during procedure). Intubation was quickly realized (T+ 4 +/- 3 min). Haemodynamics and saturation were not altered during procedure. Inhalatory induction using sevoflurane costs 6 10 versus 16 80 for intravenous target controlled propofol anesthesia (using only one preconditionned syringe). Conclusion: Inhalational induction with sevoflurane and fiberoptic intubation appeared easy, fast and cheap. |
| Databáze: | MEDLINE |
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