Preventive effect of endotracheal tube with laryngopharynx pillow cuff on cricoarytenoid joint dislocation in patients under general anesthesia and its effectiveness evaluation
10.13481/j.1671-587X.20250318
- VernacularTitle:附带咽喉枕囊气管导管对全身麻醉患者环杓关节脱位的预防作用及其效果评价
- Author:
Xiao ZHANG
1
;
Mingxin JI
;
Shirui SHAN
;
Jiahao ZHANG
;
Linyu SUI
;
Xufang SUN
Author Information
1. 吉林大学第二医院麻醉科,吉林 长春 130022
- Keywords:
Endotracheal tube;
Laryngeal pillow cushion;
Arytenoid dislocation;
Posterior commissure;
Compression injury;
Friction injury
- From:
Journal of Jilin University(Medicine Edition)
2025;51(3):740-748
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the clinical effect of tracheal tube with an attached laryngeal pillow cushion(LPC)in the patients under general anesthesia,and to provide new methods for the preventing arytenoid dislocation during tracheal intubation.Methods:Forty-eight patients scheduled for elective oral tracheal intubation under general anesthesia and meeting the inclusion criteria were selected.Based on the head and neck positions,the patients were divided into supine without pillow(SWOP)group,supine with pillow(SWP)group,trendelenburg position(TP)group,and head side position(HSP)group,each group consisted of 12 patients.The patient in the following groups underwent two sequential treatments after tracheal intubation:intervention group(LPC-inflated)and control group(LPC uninflated,representing the current method of tracheal tube use).One patient in TP group and two patients in HSP group rminated the experiment,so a total of 45 patients were successfully included in this study.Electronic fiber laryngoscopy was used to observe and record the positional relationship between the endotracheal tube LPC and the posterior commissure arytenoid joint area under different head and neck positions after two treatments.The evaluation indicators were whether the tracheal tube was lifted from the posterior commissure arytenoid joint area and the degree of compression of the tracheal tube on the arytenoid joint.The incidence of tracheal tube lift-off and the percentage of compression degree on cricoarytenoid joint of the patients in various groups were calculated.Results:Within the same head and neck position group,compared with control group,the incidence of endotracheal tube lift-off of the patients in intervention group was significantly increased(P<0.05),and the percentage of compression degree of endotracheal tube on the arytenoid joint was significantly decreased(P<0.05).In control and intervention groups,there were no statistically significant differences in the incidence of endotracheal tube lift-off and the percentage of compression degree on arytenoid joint of the patients in various head and neck positions groups(P>0.05).Conclusion:Under the four head and neck positions,inflating the LPC of the tracheal tube can lift the tracheal tube from the posterior commissure arytenoid joint area,effectively relieving or reducing the compression and mechanical friction injuries to the arytenoid joint.
