清醒气管插管的局部麻醉方法应用进展  

Application progress of local anesthesia for awake endotracheal intubation

作　　者：文笛 陈昌林[1] 万勇[1] 余祺 WEN Di;CHEN Changlin;WAN Yong;YU Qi(Department of Anesthesiology,Affiliated Hospital of North Sichuan Medical College,Sichuan,Nanchong 637000,China)

机构地区：[1]川北医学院附属医院麻醉科,四川南充637000

出　　处：《中国医药科学》2021年第24期62-65,76,共5页China Medicine And Pharmacy

摘　　要：在全身麻醉气管插管中,困难气道大多能被提前发现。既往的气道管理或术前的气道检查可以帮助麻醉医生对潜在的困难进行风险评估。清醒插管是解决预期困难气道常用的方法,对预期的困难气道患者采用清醒插管可以保障患者气道的安全,减少严重不良反应的发生。而成功的清醒插管离不开完善的气道局部麻醉。在清醒插管中,成功的气道局部麻醉是一个独特的挑战。目前临床上关于气道局部麻醉的方法有很多,本文为探讨适用于清醒气管插管的气道局部麻醉方法,将简要介绍当前常用的局部麻醉药物如利多卡因、丁卡因、罗哌卡因等,以及雾化、喷洒、神经阻滞等常用局部麻醉方法在清醒气管插管中的具体应用,结合既往研究将气道局部麻醉的方法做出简要对比,讨论这几种方法各自的优势和缺陷以及应用前景。During endotracheal intubation under general anesthesia,most difficult airways can be found in advance.The previous airway management or preoperative airway examination can help anesthesiologists assess the risks of potential difficulties.Awake intubation is a common method to solve the expected difficult airway,and it can ensure the safety of patients'airway and reduce the occurrence of serious adverse reactions.Successful awake intubation cannot be separated from perfect local airway anesthesia.Successful local airway anesthesia is a unique challenge in awake intubation.At present,there are many methods of local airway anesthesia in clinic.In order to explore the methods of local airway anesthesia suitable for awake endotracheal intubation,this paper will briefly introduce the current commonly used local anesthetics such as lidocaine,tetracaine and ropivacaine,and the specific application of atomization,spraying and nerve block in awake endotracheal intubation.Combined with previous studies,the methods of local airway anesthesia are briefly compared.The advantages,disadvantages and application prospects of these methods are discussed.

关 键 词：清醒插管 困难气道 表面麻醉 神经阻滞 纤支镜 雾化 

分 类 号：R614.2[医药卫生—麻醉学] R-1[医药卫生—外科学]