Solution for the Problem of Difficult Respiratory Tract in Planned Orthopaedic Surgery


Methods to solve the situation of difficult intubation in planned orthopaedic surgery are presented. Total number of 101 patients with problematic conventional tracheal intubation due to various orthopaedic pathology (Bekhterev's disease, abnormality of development or posttraumatic instability of cervical spine, etc.) was studied. In 49 patients tracheal intubation was performed using laryngeal mask LMA C-Trach with videovisualization (main group), in 52 patients - using fiberoptic bronchoscope (control group). The results achieved showed high efficacy of LMA C-Trach technology for solving difficult intubation problem. Application of laryngeal mask was successfully performed even in patients with Hallo-apparatus fixed cervical spine. Unlike fiber bronchoscope insertion placing of laryngeal mask was atraumatic in relation to stomatopharynx and enabled to perform adequate pulmonary ventilation till tracheal intubation. Videovisualization ensured accurate localization of trachea and its intubation with atraumatic reinforced tube under visual control. Only in 2 patients use of that technology failed and it was related to the bleeding from tonsils after multiple unsuccessful attempts of trachea intubation using direct laryngoscopy. Above described technique is not only a highly effective method for solving the problem of difficult intubation but decreases psychologic strain of the anesthesiologic team.


  1. Александров В.Н., Максимов Б.Н. Применение фиброволоконной оптики при интубации трахеи //Анестезиол. и реаниматол. - 1984. - N 2. - C. 54-56.
  2. Богданов А.Б., Корячкин В.А. Интубация трахеи. - СПб, 2004. - С. 148-157.
  3. Бримакомбе Д., Кемпбелл Р. Ларингеальная маска - новая концепция в поддержании проходимости верхних дыхательных путей //Анестезиол. и реаниматол. - 1997. - N 5. - С. 62-68.
  4. Ефремов В.А., Аржакова Н.И., Новосельцева В.А., Бессонов С.В. Современные методы решения проблемы "трудная интубация" в травматологии и ортопедии //Сб. материалов XI Всерос. конгресса анестезиологов и реаниматологов. - М., 2008. - С. 369.
  5. Латто И.П., Роузен М. и др. Трудности при интубации трахеи. - М., 1989. - С. 169-222.
  6. Лукьянов М.В., Золичева Н.Ю. Использование ларингеальной маски у больной с непредсказуемой трудной интубацией //Анестезиол. и реаниматол. - 1997. - N 4. - С. 69-71.
  7. Морган Дж.Э.-мл., Мэгид С.М. Клиническая анестезиология. - М., 1998. - Т. 1. - С. 83-98.
  8. Pennant J.H., Pace N.A., Gajraj. N.M. Use of the laryngeal mask airway in the immobilised cervical //Anesthesiology. - 1992. - Vol. 77. - P. 1063.
  9. Telfbrd R.J., Liban J.B. Awake fibreoptic intubation //B. J. Hospital Med. - 1991. - P. 182-184.



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Copyright (c) 2011 Arzhakova N.I., Efremov V.A., Bessonov S.V., Ukolov K.Y., Novosel'tseva V.A., Arzhakova N.I., Efremov V.A., Bessonov S.V., Ukolov K.Y., Novosel'tseva V.A.

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