40. Nội khí quản khó không dự kiến trước: Báo cáo 2 ca lâm sàng

Abstract

Difficult intubation, along with residual muscle relaxation and anaphylactic shock, is one of the three major challenges in the specialties of anesthesia and critical care. Difficult intubation is specifically defined as a situation where a exprienced anesthesiologist needs more than two attempts or takes longer than ten minutes but unsuccessfully. During this time, the patient is typically given muscle relaxants, leaving them unable to breathe independently or protect themselves. Therefore, predicting difficult intubation is very important. However, clinical practice frequently encounters unanticipated cases of difficult intubation, resulting in substantial risks for patients despite the existence of established protocols. Therefore, we present two cases of unanticipated difficult intubation, despite the glottic hole being clearly visible, abnormalities in the glottis or hypoglottis prevented the endotracheal tube from being correctly inserted. We had to implement various measures to resolve the issue, including the immediate reversal of neuromuscular blockade. These two cases can provide clinicians with additional options and strategies for managing real patients, beyond those outlined in standard protocols.