[Anesthetic technics for the difficult intubation].
Numerous anaesthetic techniques exist for a patient who presents with a difficult endotracheal intubation. They all require an anaesthetic protocol which cannot be improvised. When intubation is expected to be difficult at the pre-anaesthetic examination, the use of a fiberoptic bronchoscope is the technique of choice for intubating adults under local anaesthesia, and children under general anaesthesia. When a fiberoptic bronchoscope is not available, several alternatives can be suggested: local anaesthesia of the glottis, retro-molar and retrograde intubation, or the use of a guide threaded over a lighted stylet; these techniques can be used in an anaesthetized patient breathing spontaneously. In the paralyzed patient impossible to intubate, various trans-laryngeal techniques of ventilation can be used in emergency: jet ventilation via the trans-crico-thyroid route, the use of a cricotomy cannula, or a minitracheotomy set.
Boufflers
E
E
Département d'Anesthésie-Réanimation Chirurgicale I, Hôpital B, Centre Hospitalier Régional, Lille.
Hannebicque
V
V
Niset
M
M
Reyford
H
H
Krivosic-Horber
R
R
D000758:Anesthesia / Q000379:methods*; D004630:Emergencies; D005336:Fiber Optic Technology; D006221:Halothane; D006611:High-Frequency Jet Ventilation; D006801:Humans; D007442:Intubation, Intratracheal; D007828:Laryngoscopy; D008874:Midazolam; D014140:Tracheotomy
D008874:Midazolam; D006221:Halothane
Techniques d'anesthésie pour intubation difficile.