颈部手术后气道梗阻预防及管理的最佳证据总结.docxVIP

颈部手术后气道梗阻预防及管理的最佳证据总结  Introduction Neck surgery is a complex medical procedure that involves various potential risks to the patients health. One of the most significant complications is airway obstruction, which can occur both during and after the surgery. The prevention and management of airway obstruction after neck surgery are critical to the patients safety and recovery. In this paper, we aim to evaluate the best available evidence on strategies for preventing and managing airway obstruction after neck surgery. Preoperative considerations Preventing airway obstruction after neck surgery begins with careful preoperative assessment and preparation. Many factors can increase the risk of airway obstruction, including obesity, obstructive sleep apnea, difficult airway anatomy, and comorbidities such as cardiovascular disease and diabetes. Identifying and addressing these risk factors is essential to reduce the chances of airway obstruction during and after surgery. Preoperatively, patients should be evaluated for any potential airway issues that may affect the surgery. These may include upper airway narrowing or muscle weakness, and the usual recommendations include conducting awake fibreoptic intubation to avoid problems during anaesthesia. Other strategies to prevent airway obstruction during surgery include avoiding the use of muscle relaxants or using shorter acting ones. It is important to ensure that the anaesthesia team has experience managing patients with difficult airways to minimise complications. Intraoperative management During the surgery, several intraoperative strategies can reduce the likelihood of airway obstruction. For instance, maintaining head and neck positioning with a chin lift or jaw thrust can help keep airways open. Appropriate patient positioning is essential and requires a stable neck support. In addition, avoiding the use of bulky dressings and applying appropriate positioning manoeuvres like keeping the neck in a neutral posit