Copa method for fiberoptic endotracheal intubation

Surgery – Endoscope – Having endotrachael intuabation means on endoscope

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12820714, A61B 104

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active

059760729

ABSTRACT:
For fiberoptic endotracheal intubation, a method is disclosed that uses a device having a cannula with a first, distal end for placement within the pharynx of a patient, a second, proximal end for being disposed outside of the patient's oral cavity, and a flow passage between the first and second ends. The cannula has a length such that, when the distal end is placed within the pharynx, it terminates distally at a point near the patient's epiglottis. The device includes an inflatable cuff structure for forming a seal between a wall of the cannula and the patient's pharynx. The cuff is positioned adjacent to the distal end of the device and defines, on inflation, a ventral/anterior portion and a posterior portion. The method involves a step of inserting the device, with cuff deflated, into a patient's mouth so that the distal end of the device is disposed at a point near the patient's epiglottis to establish an airway column down the core of the device. Once the cuff structure is inflated, the patient's airway is supported to provide spontaneous breathing and controlled ventilation through the flow passage of the device. Then, a fiberoptic scope, on which an endotracheal tube has been preloaded so that the distal tip of the scope projects beyond the endotracheal tube, is inserted into the patient through the patient's oral cavity so that the lip is in the throat past the uvula, whereby after insertion of the device and insertion of the fiberoptic scope, the scope is disposed exteriorly of the device. Then, the tip of the fiberoptic scope is advanced so that it enters the trachea. The endotracheal tube is then advanced through the oral cavity and into the trachea using the fiberoptic scope as a guide. Finally, the fiberoptic scope is removed from the trachea.

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Ovassapian, Andranik; Fiberoptic Tracheal Intubation in Adults; Fiberoptic Endoscopy and the Difficult Airway; Chapter 6, pp. 71-103.
Ovassapian, Andranik; Pediatric Fiberoptic Intubation; Fiberoptic Endoscopy and the Difficult Airway; Chapter 7, pp. 105-115.
Ovassapian, et al; Fiberoptic Tracheal Intubation with Combitube in Place; Anesth Analg 1993;76;S1-S476.
Ozaki, et al.; Direction Dependence of Thermoregulatory Vasoconstriction During Isoflurane-Epidural Anesthesia; Anesth Analg 1993;76;S1-S476.
Benumof Jonathan L.; Fiberoptic Tracheal Intubation With The Combitube in Place; Airway Management; pp. 252-253.
Ovassapian, Andranik and Wheeler, Melissa; Fiberoptic Endoscopy-Aided Techniques; Chapter 16, p. 319.

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