ラリンゴマイクロサ-ジェリ-におけるHigh Frequency Jet Ventilationの使用経験 (高頻度人工呼吸(HFV)<特集>)
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Microsurgery of the larynx using direct laryngoscope is becoming an increasingly popular technique in the field of otolaryngology. A variety of technique for anesthesia have been developed for this procedure. However, in spite of the proponents being satisfied with these techniques, all of them have some disadvantages.<BR>High frequency jet ventilation (HFJV) has been used in recent years for respiratory fail ure and endolaryngeal surgery. In the present report, the authors describe the clinical experience of 14 patients who had laryngomicrosurgery under general anesthesia with intravenous agents using HFJV.<BR>Three methods were employed for HFJV. One is the method using so-called Carden tube. After orotracheal intubation, HFJV was performed through the tip of the Carden tube into the trachea. In the second technique, metal catheter attached to the blade of the direct laryngoscope was used for HFJV. Percutaneous transtracheal method was employed for the third one, in which a 18 gauge intravenous catheter was used for HFJV percutaneo usly through the cricothyroid membrane. All of these three methods provided a good surgi cal field of vision. However, in the latter two methods described above, especially in the third method, PaCO<SUB>2</SUB> had a tendency to rise during the surgical procedure. Severe subcutaneous emphysema was experienced in a case the second methcd was employed. Carden tube method, to be favorable technique for HFJV, because we did not have any complications during the procedure.
- 特定非営利活動法人 日本気管食道科学会の論文
特定非営利活動法人 日本気管食道科学会 | 論文
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