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KMID : 0356919950290020304
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Korean Journal of Anesthesiology
1995 Volume.29 No. 2 p.304 ~ p.309
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Retrograde Tracheal Intubation through Cricothyroid Membrane and Cricotracheal Ligament
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윤상민
김영생/조성두/송남원
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Abstract
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Numerous devices and techniques have been devised to facillitate the difficult endotracheal intubation. Percutaneous retrograde intubation was first described by Waters, who used a Tuohy needle to puncture the cricothyroid membrane and an
epidural
catheter as a guideline in 1963 and many variations on the technique have been described. Failure to intubate 2 male adult patients were planned retrograde tracheal intubation using the cricothyroid membrane. While the patients were awake, and
after
adequate local anesthesia was obtained, a 16G Medicut(r) was punctured through cricothyroid membrane. After confirmation of the intratracheal position by aspiration of air into syringe, the opening of the Medicut was directed upward forward the
alrynx
and the epidural catheter was inserted through it and advanced retrograde between the vocal cords and into mouth. The epidural catheter tip was passed through the Murphy's eye from outside to inside and out of the tracheal tube. By keeping the
catheter
taut and coincidently pulling back, the tube was advanced into trachea. Correct positioning of the tracheal tube inside the trachea was confirmed by end-tidal carbo dioxide monitoring and auscultation. Another 2 male adult patients were intubated
by
using cricotracheal retrograde approach method. We experienced successful retrograde tracheal intubation without significant complications using an epidural catheter through cricothyroid membrane and cricotracheal ligament in 4 male adult
patients
who
were predicted impossibility of simple orotracheal intubation. (Korean J Anesthesiol 1995; 29: 304~309)
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KEYWORD
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