Management of the difficult adult airway. With special emphasis on awake tracheal intubation.

摘要: Difficulty in managing the airway is single most important cause of major anesthesia-related morbidity and mortality. Successful management a difficult begins with recognizing potential problem. All patients should be examined for their ability to open mouth widely structures visible upon opening, size mandibular space, assume sniff position. If there good possibility that intubation and/or ventilation by mask will difficult, then secured while patient still awake. In order an awake successful, it absolutely essential properly prepared; otherwise, anesthesiologist simply fulfill self-defeating prophecy. Once prepared, likely any one number techniques successful. already anesthetized paralyzed found many repeated attempts at avoided because progressive development laryngeal edema hemorrhage develop ventilate lungs via consequently may lost. After several intubation, best awaken patient, do semielective tracheostomy, or proceed case using ventilation. event lost patient's cannot ventilated, TTJV instituted immediately. Tracheal extubation over jet stylet permits controlled, gradual, reversible (in reintubation possible time) withdrawal from airway. Significant advances have occurred recent years. Eighty percent 127 references this article were published after 1985. However, much more learn regard recognition airway, preparation new endotracheal establishment gas exchange who intubated ventilated mask. As anesthesiologist's manage significantly improves, respiratory-related mortality decrease.