CAJ | 학술논문

目的：探讨氟骨症性颈椎管狭窄症手术的麻醉特点及管理方法。方法对2009年2月～2014年3月5例氟骨症性颈椎管狭窄症的麻醉管理进行总结。2例术前颈椎活动严重受限，改良Mallampati分级Ⅲ级，考虑可能为困难气管插管，清醒表面麻醉下行纤维支气管镜引导气管插管；余3例为非困难气管插管，行快速诱导直视下Macintosh喉镜气管插管。结果5例均安全度过围术期，无死亡。1例因呼吸功能不全，术后转入ICU病房，次日拔管；余4例术后转入PACU拔管。术后均无麻醉相关并发症，顺利出院。结论氟骨症性颈椎管狭窄症患者困难气道发生率高，气道管理是围术期麻醉管理的核心问题。
목적：탐토불골증성경추관협착증수술적마취특점급관리방법。방법대2009년2월～2014년3월5례불골증성경추관협착증적마취관리진행총결。2례술전경추활동엄중수한，개량Mallampati분급Ⅲ급，고필가능위곤난기관삽관，청성표면마취하행섬유지기관경인도기관삽관；여3례위비곤난기관삽관，행쾌속유도직시하Macintosh후경기관삽관。결과5례균안전도과위술기，무사망。1례인호흡공능불전，술후전입ICU병방，차일발관；여4례술후전입PACU발관。술후균무마취상관병발증，순리출원。결론불골증성경추관협착증환자곤난기도발생솔고，기도관리시위술기마취관리적핵심문제。
Objective-To-explore-the-anesthetic-management-during-operation-for-fluorosis-cervical-stenosis-.-Methods-The-demographic-data,-surgical-parameters-,-and-anesthetic-management-of-5-patients-with-fluorosis-cervical-stenosis-from-February-2009-to-March-2014-were-analyzed-.Two-of-the-5-patients-had-severely-limited-movement-of-cervical-spine-and-were-classified-as-Mallampati-grade-Ⅲ.Both-of-them-received-awake-fiberoptic-intubation-under-topical-anesthesia-.The-remaining-three-patients-had-no-difficulty-in-tracheal-intubation-and-were-intubated-with-Macintosh-direct-laryngoscope-under-rapid-anesthesia-induction-.-Results-All-the-patients-underwent-the-surgery-smoothly-,-without-deaths-during-the-perioperative-period-.After-surgery,-1-patient-was-transferred-to-the-ICU-due-to-respiratory-insufficiency-and-was-extubated-on-the-following-day-.The-remaining-4-patients-were-transferred-to-the-PACU-and-had-the-tracheal-tube-removed-there-afterwards-.All-the-patients-had-no-anesthesia-related-complications-after-operation-and-were-discharged-uneventfully-.-Conclusions-Patients-with-fluorosis-cervical-stenosis-have-a-high-incidence-of-difficult-airway-.Airway-management-is-the-key-of-perioperative-anesthetic-management-.