Endotracheal intubation following thyroidectomy

Thirty-five patients requiring tracheostomy or endotracheal intubation, following thyroidectomy are reviewed. Conditions included 30 patients with multinodular goitre, three patients with Graves's disease and two patients with carcinoma of the thyroid. Early in the series, emergency tracheostomy was performed in three patients with airway obstruction following thyroidectomy. Ten patients were deemed at extremely high risk of developing airway obstruction and underwent prophylactic tracheostomy. Endotracheal intubation has been used in preference to tracheostomy in the latter part of the series. Emergency endoctracheal intubation was performed on one patient and prophylactic intubation was carried out in 20 patients. The morbidity and length of hospital stay in this latter group was considerably less than those requiring tracheostomy. It is concluded that patients with potential airway obstruction following thyroidectomy should have prophylactic endotracheal intubation, in preference to tracheostomy.     

非肌松药条件下的气管插管技术

目前临床麻醉中最常用的是通过起效快的镇静药和阿片类镇痛药进行麻醉诱导,辅以去极化或非去极化肌肉松弛药后再行气管插管.虽然这种快速麻醉诱导方法为气管插管提供良好的肌松条件,但肌肉松弛药的一些剐作用使得其在某些条件下的应用受到限制,甚至带来一些潜在隐患.随着新型强效的镇静药、吸入麻醉剂和阿片类药物的问世和广泛临床应用,人们对在不用肌肉松弛药条件下的气管插管技术兴趣增加,相关研究越来越广泛.