Who should not get intubation anesthesia?
Intubation also carries some risks, such as injury to the vocal chords or other structures in the mouth and throat area, which can lead to swallowing and speech disorders and even loss of voice. Therefore, intubation should only be performed for the above mentioned indications. Short operations on the extremities, the urogenital tract (except laparoscopic procedures) or the skin can be performed under general anesthesia and use of a laryngeal mask or possibly even under regional anesthesia.
Procedure of intubation anesthesia
The patient is placed in a supine position with the head slightly elevated on a small pillow. A venous access is made in advance to administer the necessary medication. A strong painkiller (e.g. sufentanil or fentanyl) is administered first.
Next, the anaesthetic (usually propofol) is injected. If the patient sleeps and stops breathing, the patient is first ventilated with a mask that is placed firmly on the face. Then a muscle relaxant is injected (e.g. cis-atracurium or succinylcholine), which relaxes all the muscles of the body and especially the muscles of the larynx.
The glottis opens and the tube (breathing tube) can be inserted into the trachea with the help of a spatula (laryngoscope). The balloon around the tube is inflated (=blocked) via a small tube, thus closing the trachea. Air can now only be administered via the lumen of the tube. The breathing tube is connected to the ventilator via a hose system, which takes over breathing for the sleeping patient.
Anaesthetic induction
Introduction means the transfer of the awake patient into the deeply sleeping patient. In the process, pain, consciousness and muscle power are eliminated. Three groups of medication are required for this – strong painkiller (e.g. sufentanil), narcotic (propofol) and muscle relaxant (e.g. cis-atracurium).The process of intubation and setting the ventilator is also part of the introduction. At the end of the intubation, the patient is positioned for the operation, whereby care must be taken to ensure that the body parts are positioned gently and axially correct in order to avoid positioning damage.
