左头旋转 (LeHeR) 机动对直接喉腔镜视图的影响:一项观察性研究
Lokeshshiva Arul1, Sunil Rajan1, V K Sai Sandhya1
1Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
Journal of anaesthesiology, clinical pharmacology
|November 3, 2025
概括
与嗅探位置相比,左头旋转 (LeHeR) 机动显著改善了喉视觉在喉镜检查期间. 这种技术使输管更容易,成功率高,血液动力学稳定.
科学领域:
- 麻醉学 麻醉学
- 航空航道管理的管理.
背景情况:
- 呼吸道管理困难是麻醉中关键问题之一.
- 直接喉腔镜是一种常见的呼吸道可视化方法.
- 优化患者的定位可以改善喉视图.
研究的目的:
- 评估左头旋转 (LeHeR) 机动在直接喉镜检查期间改善喉视力的有效性.
- 为了将LeHeR位置与Cormack-Lehane (CL) 分级的经典嗅探位置进行比较.
- 通过LeHeR机动来评估输管易度,成功率和血液动力学变化.
主要方法:
- 一项前性观察性研究,涉及130名成年手术患者 (ASA身体状况1-2).
- 被排除在外的患者有CL级1或口腔开口受限.
- 直接喉腔镜检查首先在嗅探位置进行,然后将头部旋转45°向左 (LeHeR位置).
主要成果:
- 在76.9%的患者中,LeHeR位置改善了眼视野.
- 在LeHeR位置 (95.38%) 中,相比于嗅探位置 (73.8%),显著更高的比例的患者在LeHeR位置 (95.38%) 中达到CL等级1-2B.
- 对大多数患者来说,LeHeR位置的输管成功,使用布吉的比例很低,没有显著的不良血液动力学影响.
结论:
- 与嗅探位置相比,在45°的LeHeR机动提供了更好的喉视图.
- 这种定位有助于更容易的直接喉腔镜和输管.
- LeHeR技术是安全的,有效的,并且与良好的第一次试验输管成功相关,没有显著的血液动力学妥协.
相关概念视频
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
459
Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
459
Endoscopic Studies I: Bronchoscopy and Thoracoscopy
503
Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
503
Suctioning the Oropharyngeal Airway
777
In preparing for oropharyngeal airway suctioning, a nurse must gather all necessary equipment, including a suction unit with tubing, a prepackaged suction kit, sterile gloves, water or saline for irrigation, a water-soluble lubricant, and additional personal protective equipment (such as a gown, mask, and goggles) to control infections.
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
777
Cardiopulmonary Resuscitation II: ACLS Airway Management
509
Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
509
Endoscopic Studies II: Thoracocentesis
1.2K
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
1.2K
Endoscopic Procedures I: Esophagogastroduodenoscopy
862
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
During an EGD, the endoscope can be used to:
862


