THE SAFETY OF AWAKE TRACHEAL INTUBATION IN CERVICAL-SPINE INJURY

被引:44
作者
MESCHINO, A
DEVITT, JH
KOCH, JP
SZALAI, JP
SCHWARTZ, ML
机构
[1] UNIV TORONTO,SUNNYBROOK HLTH SCI CTR,DEPT ANAESTHESIA,2075 BAYVIEW AVE,TORONTO M4N 3M5,ONTARIO,CANADA
[2] UNIV TORONTO,SUNNYBROOK HLTH SCI CTR,DEPT NEUROSURG,TORONTO M4N 3M5,ONTARIO,CANADA
[3] UNIV TORONTO,SUNNYBROOK HLTH SCI CTR,DEPT BIOSTAT,TORONTO M4N 3M5,ONTARIO,CANADA
来源
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE | 1992年 / 39卷 / 02期
关键词
COMPLICATIONS; INTUBATION; TRAUMA; TRACHEAL; TECHNIQUE; SURGERY; ORTHOPEDICS; CERVICAL SPINE;
D O I
10.1007/BF03008639
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
As a referral centre for cervical spine injuries, we have routinely performed awake tracheal intubation when intubation was indicated. A retrospective case control study was undertaken to review the frequency of neurological deterioration and aspiration associated with our approach. Neurological deterioration was assessed by a change in level of injury or neurological grade at admission and discharge. Four hundred and fifty-four patients with critical cervical spine and/or cord injuries were reviewed over an eight-year period A case group of 165 patients underwent tracheal intubation awake within two months of injury. A control group of 289 remained unintubated during the same period. A comparison of spinal neurological status between admission and discharge revealed no statistically significant difference in neurological deterioration between the two groups. This occurred despite a greater injury severity score in the case group. No evidence of aspiration during intubation was documented. We conclude that awake tracheal intubation is a safe method of airway management in patients with cervical spine injuries.
引用
收藏
页码:114 / 117
页数:4
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