PDF(Pubmed)
Abstract：
BACKGROUND: Fiberoptic-guided intubation is considered as \"gold standard\" of difficult airway management. Management of the airway in prone position in patients with severe trauma presenting with penetrating waist and hip injury poses a major challenge to the anesthesiologist.
METHODS: A man presented with severe multiple trauma and hemorrhagic shock as a result of an industrial accident with several deformed steel bars penetrating the left lower waist and hip. It was decided to schedule an exploratory laparotomy following extracting the deformed steel bars. Successful administration of awake fiberoptic nasotracheal intubation, performed in a prone position under airway blocks and appropriate sedation, allowed for the procedure. The exploratory laparotomy revealed damage to multiple organs, which were repaired sequentially during a 7-hour surgical operation. The patient\'s recovery was uneventful, and he was discharged from the hospital one month after the surgery.
CONCLUSIONS: Awake fiberoptic nasotracheal intubation, along with airway blocks and appropriate sedation, can be a viable option in patients with severe multiple trauma in the prone position.
METHODS: A man presented with severe multiple trauma and hemorrhagic shock as a result of an industrial accident with several deformed steel bars penetrating the left lower waist and hip. It was decided to schedule an exploratory laparotomy following extracting the deformed steel bars. Successful administration of awake fiberoptic nasotracheal intubation, performed in a prone position under airway blocks and appropriate sedation, allowed for the procedure. The exploratory laparotomy revealed damage to multiple organs, which were repaired sequentially during a 7-hour surgical operation. The patient\'s recovery was uneventful, and he was discharged from the hospital one month after the surgery.
CONCLUSIONS: Awake fiberoptic nasotracheal intubation, along with airway blocks and appropriate sedation, can be a viable option in patients with severe multiple trauma in the prone position.
摘要：
背景：光纤引导插管被认为是困难气道管理的“金标准”。严重创伤伴穿透性腰部和臀部损伤的患者俯卧位气道的管理对麻醉师构成了重大挑战。
方法：一名男子因工业事故而出现严重的多发伤和失血性休克，几根变形的钢筋穿透了左下腰和臀部。决定在提取变形的钢筋后进行剖腹探查手术。清醒的光纤鼻气管插管的成功管理，在俯卧位下进行气道阻塞和适当的镇静，允许的程序。剖腹探查术显示多个器官受损,在7小时的外科手术中依次修复。病人的康复顺利，手术后一个月就出院了.
结论：清醒光纤经鼻气管插管，伴随着气道阻塞和适当的镇静，对于俯卧位的严重多发伤患者，可以是一个可行的选择。
方法：一名男子因工业事故而出现严重的多发伤和失血性休克，几根变形的钢筋穿透了左下腰和臀部。决定在提取变形的钢筋后进行剖腹探查手术。清醒的光纤鼻气管插管的成功管理，在俯卧位下进行气道阻塞和适当的镇静，允许的程序。剖腹探查术显示多个器官受损,在7小时的外科手术中依次修复。病人的康复顺利，手术后一个月就出院了.
结论：清醒光纤经鼻气管插管，伴随着气道阻塞和适当的镇静，对于俯卧位的严重多发伤患者，可以是一个可行的选择。
