视频喉镜在挑战性气道处理中的应用

Application of Video Laryngoscopy in Management of Challenging Airways

视频喉镜的应用已导致气道管理方法发生明显的变化,并被视为气管插管技术的革命性进步。虽然目前缺乏统一的意见,但视频喉镜在手术室内外气道管理中的应用正在逐渐普及,并已快速成为解决潜在性和(或)意外性困难气管插管的有效工具。目前认为,对于挑战性困难气道患者,视频喉镜较直接喉镜能改善喉显露。且无论是新手还是经验丰富的麻醉医师,视频喉镜均容易使用,所需的操作技能容易掌握,故可能成为临床气道管理的一线工具。通过阐述视频喉镜在院前、急诊科、重症监护室气道管理及颈椎固定患者气管插管和肥胖患者清醒气管插管时的应用,旨在确定视频喉镜在不同挑战性气道患者中的性能,并识别其可能的局限性。

The introduction of video laryngoscopy has resulted in a dramatic transformation of clinical airway manage- ment and is regarded as a revolutionary step in intubation technology. There is the lack of uniformity and the need of further investigation, but video laryngoscopy continues to gain popularity both inside and outside the operating room, and has rapidly become an effective tool for potential and/or encountered difficult intubations. It is believed that video laryngoscopy improves laryngeal view compared with direct laryngoscopy in patients with challenging difficult airways. Furthermore ,video laryngoscopy is easy to use for novices and experienced anesthesiologists, and the required skills are easy to master. Thus, it may become a first-line tool for clinical airway management. By describing the use of video laryngoscopy in airway management of prehospital setting, emergency department, intensive care unit, and in intubation of patients with cervical spine immobilization, and in awake intubation of obese patients, this review aimed to determine the performance of video laryngoscopy in the various challenging airway conditions, and identify its potential limitations.