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Limitations of jet ventilation through the laryngoscope


, : Limitations of jet ventilation through the laryngoscope. Canadian Anaesthetists' Society Journal 29(2): 117-120

A series is presented of 100 patients who underwent direct laryngoscopy under general anesthesia. The preferred technique of ventilation is jet insufflation by an injector attached to the blade of the laryngoscope, as it provides the surgeon with a quiet and completely exposed larynx. In 9 cases chest expansion was assessed as inadequate by the anesthetist. These patients were obese with a short neck, and/or stiff-necked; thus, insertion of the laryngoscope was difficult and a good seal between it and the larynx could not be achieved. Arterial blood gas values in 6 of these patients demonstrated marked hypoventilation. To improve ventilation in these patients, an alternative technique of insufflation through a nasotracheal catheter was used. Arterial blood gas values indicated that this method resolved the problem of hypoventilation. Although the catheter somewhat limits the view of the endolarynx, the improved ventilation outweighs the drawbacks of this technique. Apparently, for the obese and/or stiff-necked patient, a nasotracheal catheter should be used electively for ventilation.

US$19.90

PMID: 6802468

DOI: 10.1007/bf03007988


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