Kinking of Disposable Fiberoptic Bronchoscope During Difficult Nasal Awake Intubation

L. Bordenave, C. Motamed, M. Abdellaoui
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Abstract

Background: disposable fiberoptic for intubation are more and more available in operating room We hereby report a complication of a difficult fiberoptic intubation performed with a disposable fiberscope. Case: Under remifentanil sedation Visualizing the glottis was easy while advancing the endotracheal tube through the fiberscope was mildly difficult. Removing the fiberscope was impossible as was the removal of the endotracheal tube. The patient was becoming uncomfortable. Under local anesthesia we performed a jet ventilation after puncture of the cricothyroid membrane followed by total intravenous anesthesia. A cervicofacial surgeon visualized the kinking of the fiberscope at the tip of the endotracheal tube. The fiberscope was removed under direct vision with a rigid bronchoscope. Conclusion: Because of more flexibility disposable fiberscopes may kink during the introduction of the endotracheal tube.
一次性纤维支气管镜在困难鼻清醒插管时的扭结
背景:一次性光纤插管在手术室的应用越来越广泛,我们在此报告一例使用一次性光纤镜插管困难的并发症。病例:在瑞芬太尼镇静下,声门可见容易,而通过纤维镜推进气管内管有轻度困难。除去纤维镜和气管内管是不可能的。病人变得不舒服了。在局部麻醉下,我们在穿刺环甲膜后进行喷射通气,然后进行全静脉麻醉。一名颈面外科医生在气管内管的尖端看到纤维镜的扭结。在刚性支气管镜直视下取出纤维镜。结论:一次性纤维镜由于弹性大,在气管插管过程中可能发生扭结。
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