困難気道患者における高流量鼻カニューレ酸素療法を併用した鎮静下気管支ファイバースコープ挿管および抜管の経験

Sedated Fiberoptic Tracheal Intubation and Extubation Using High-Flow Nasal Cannula Therapy in a Patient with a Difficult Airway

要旨

　頸部瘢痕拘縮および声門浮腫により困難気道を有する患者に対し，高流量鼻カニューレ酸素療法（high flow nasal cannula therapy：HFNCT）を併用して，鎮静下経口気管支ファイバースコープ挿管と抜管を実施した。HFNCTは，操作中自発呼吸下でSpO₂を99-100％に維持し，気道を十分に開存した。

　We performed used high-flow nasal cannula therapy（HFNCT）while performing sedated oral fiberoptic intubation in a patient with an airway that was expected to be difficult due to cervical scar contracture. Sedation with propofol and fentanyl and topical lidocaine anesthesia allowed manipulation of the fiberoptic intubation while preserving the patient’s spontaneous breathing. Tracheal intubation was successfully completed within 8 minutes, with the SpO₂ maintained at 99％-100％ throughout the procedure. The concurrent use of HFNCT facilitated safe and controlled tracheal intubation, and it contributed to the airway conditions allowing tracheal extubation.