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3.
Anesth Analg ; 106(1): 182-5, table of contents, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18165576

RESUMO

BACKGROUND: We compared two emergency cricothyroidotomy kits designed to avoid lesions during insertion, one based on the Seldinger technique (ST), the other based on the concept of a mechanical detection of the posterior wall of the larynx, with regard to insertion time, success rate, and complication rate. METHODS: Cricothyroidotomy was performed under fiberoptic control in 40 human cadavers embalmed according to Thiel's technique. The set chosen for use was randomized: new technique (NT) or ST. Duration of the procedure, success rates, and incidence of laryngeal injuries were compared. Traumatic lesions observed with the fiberoptic bronchoscope were anatomically confirmed after dissection. RESULTS: The two groups had comparable epidemiological and anatomical records. Cricothyroidotomy was performed faster with the NT than with the ST (median 54 vs 71 s, P = 0.01). Failure rates were comparable between groups (4 vs 1, P = 0.34), and there were fewer major complications in the posterior tracheal wall with the ST (0 vs 8, P = 0.003). In the ST group, only minor punctiform lesions of the posterior trachea wall were observed in four cases. CONCLUSIONS: In this model, despite a shorter insertion time, the NT produced more lesions and more failures than the ST.


Assuntos
Cartilagem Cricoide/cirurgia , Serviços Médicos de Emergência , Intubação Intratraqueal/métodos , Cartilagem Tireóidea/cirurgia , Idoso , Idoso de 80 Anos ou mais , Broncoscópios , Cadáver , Feminino , Tecnologia de Fibra Óptica , Humanos , Intubação Intratraqueal/efeitos adversos , Intubação Intratraqueal/instrumentação , Laringe/lesões , Masculino , Distribuição Aleatória , Fatores de Tempo , Traqueia/lesões , Falha de Tratamento , Resultado do Tratamento , Ferimentos e Lesões/etiologia
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