1.

( fibrosis)

2.

Difficult intubation LEMON

Look externally

Evaluation3-3-2 3 3

3 3

2 2

Mallampati Mallampati

(1)
 (2) I

(3) II

(4) III

(5) IV

Obstruction

Neck mobility (AS)

Masking Mask

3C C mask

ventilation(pre-oxygenation)

( 3-4 )

difficult ventilation MOANS

Mask saal

Obesity

Obstruction

Age 55

No teeth

Stiff lung compliance

 difficult ventilation

(1) mask

(2) nasaloral airway

(3) mask( nasal airway)

Laryngeal mask LMA

NPO aspiration

LMA Size

<5 5-10 10- 20- 30- 50- 70-

20 30 50 70 99

LMA size 1 1.5 2 2.5 3 4 5

LMA 4 7 10 14 20 30 40

LMA RODS

Restricted oral opening LMA

Obstruction

Disrupted/ distorted

Stiff lung

 1. sniffing position

(1) head tilt-chin lift

(2) Jaw thrust

2. Endo ()

(1) 3+age/4

(2) 7.5-9

(3) 7-8

3. Endo carina 5cm

22-24cm

check one lung

4. (ex.)

5. video-assisted

CICOcannot intubatecannot oxygenate

1. endo mask

2. cricothyroidotomy endo

3. circothyroidotomy SHORT

Surgery

Hematoma /
 Obesity

Radiation

Tumor

(COMPARISON
OF NEUROMUSCULAR BLOCKING AGENTS)
hiopental

( Barbiturate )


2.5%

PH 10

11

24

hiopental

BBB

GABA

synapse

3
5mg/kg

20

15 20

1.

2.

3.

4. Sympathetic nerve Parasympathetic nerve

5.

thiopental

thiopental

4 6mg/kg
1.

2. 2.5%
 6 10ml

3. 2.5% 2 3ml

4. 2% 15 20mg/kg

thiopental
1.

2.

Ketamine phencyclidine PH 3.5 5.5

NMDA

Thalamus brain stem Limbic system

1. 30 60

15 20 5 15

2.

3. Sympathetic nerve

4.

5.

6.

 1.

2. 0.1% 0.2mg/kg/min

3.

4. 5 10mg/kg im 30min

1.

2.

Propofol 1.5

2.0mg/kg 30 40 3 10min

1.

2.

BP HR C.O.

3.

1.5 2.0mg/kg
1.

2.

3. 2mg/kg/h 10
 2hrs

4. 1 2mg/kg/h

1.

2. thiopental

3. 3%

Midazolam benzodiazepines

30min 1.5 2.5

90 96 60

40

1.

2.

3. 7.5mg 15mg po 30min 10~15mg

im 2.5 5mg IV 5 10mg

1.

2.

3. 3

1.
 2.

3.

< >

Thiopental Ketamine Propofol Midazolam

CNS

2+ 1+

HR

BP

C.O

Vessel Dilation dilation dilation

thiopental

(mg/kg) 4~6(iv) 1~2(iv) 1.5~2(iv) 1~1.5(iv)

60sec 30~60sec 30~40sec 30~60sec

 15~20min 10~15min 3~10min 5~10min

thiopental

(hr) 3 12 12 0.5 1.5 1.5 2.5

B enzodiazepine

NMDA