使用插管式呼吸道喉頭罩淤困難插管病患作盲目氣管內插管

Use of the Intubating Laryngeal Mask Airway for Blind Endotracheal Intubation in Patients with Difficult Airways

插管式呼吸道喉頭罩於處理氣管內管插管困難之病患上，扮演－重要角色。本研究從1999年8月至2000年2月間，共隨機收錄17位喉頭目視分類第四等級之外科手術病患，該17位病患皆使用插管式呼吸道喉頭罩作氣管盲目插管。氣管內管盲目插管成功率為88.2%，其中58.8%為首次嘗試成功，17.6%病患需調整喉頭罩位置一次才成功，11.08%則需多於一次調整喉頭罩位置才能插管成功。另外兩位無法盲目插管成功者，則以支氧管鏡協助下成功放置氣管內管。本研究結論為於處理插管困難之病患，使用插管式呼吸道喉管罩作盲目氣管內管插管，其成功率甚高。於處理氣管內管插管困難之病患，扮演一重要角色。

The intubating laryngeal mask airway has been served as the alternative management for the endotracheal intubation in patients with difficult airways. Seventeen patients with laryngoscopic view classification IV were encountered during routine anesthetic practice from August 1999 to February 2000. Intubating laryngeal mask airway was used to facilitate blind endotracheal intubation in each of the patients. The overall successful rate of blind endotracheal intubation was 88.2%; 58.8% of them were completed only in a single attempt; 17.6% required one adjustment of ILMA; 11.8% required more than one adjustment. The two cases (11.8%) that we failed to intubate were managed by fiberoptic bronchoscopy guided intubation via the intubating laryngeal mask airway as a conduit. In conclusion, the intubating laryngeal mask airway could he used successfully for blind intubation in patients with predicted difficult intubation.