Since the surgery, the medical community has actually attempted to perform acts of anesthesia aims to reduce and eliminate pain or pain. (Anonymous, 1989) In principle, a patient will be unconscious to perform actions that are performed physical such as hitting, choking, and so forth. It had to be done so that the patient does not feel pain, and finally jumped off the table which resulted in disruption of the proceedings of operation. (Anonymous, 1986).
Since the introduction of ether gas usage by William Thomas Greene Morton in 1846 in Boston United States, then gradually in ways that physical violence is often done to achieve a state of anesthesia becoming obsolete. Discovery was a turning point in the history of surgery, because it opens up the possibility of surgical horizons broader, easier and humane. (Anonymous, 1986).
In an operation, a surgeon can not work alone in dissecting patients while creating a state of anesthesia. Required the presence of an anesthetist to seek, handle and maintain a state of anesthesia the patient. The job of an anesthesiologist in an operating event include:
A. Relieve pain and emotional stress during the process of doing surgery or other medical procedures.
2. To manage common medical measures to the patients operated, keeping the functions of the organs of the body goes in the normal range so that patient safety is maintained.
3. Create the best possible operating conditions so that the surgeon can perform their duties easily and effectively.
One business that absolutely must be performed by an anesthesiologist is to maintain the functioning of organs in normal patients, with no significant effect due to the surgical process. Airway management became one of the most important part in an act of anesthesia. Because some of the effects of drugs used in anesthesia may affect the state of the airway goes well.
One attempt to maintain the patient's airway with endotracheal intubation action, namely by inserting a tube into the upper respiratory tract. Because the main requirements that must be considered in the general anesthesia is to keep the airway and breathing are always free to run smoothly and orderly. In fact, according to Halliday (2002) use of endotracheal intubation is also recommended for neonates with complicating factors that can interfere with the airway. This paper will elaborate on endotracheal intubation, and will only be limited to the issue.
Anatomy and Physiology
2.1 Anatomy - Upper Respiratory Physiology.
Endotracheal intubation in action we must first understand the anatomy and physiology of the upper airway where intubation was installed. In the discussion of the anatomy and physiology, the authors will elaborate on some matters relating to the physiology of the oropharynx cavity, naso pharynx and some will be more emphasized in the larynx.
Human respiratory system has a picture of a common design that can be attributed to a number of important activities. This system would essentially consist of surface respiration and branched into conducting passages that make up the respiratory tree. Surface respiration is an area of approximately 200 m2, and forming something very thin, moist barrier to air and blood capillaries surrounding the millions of bags called alveoli that eventually form a mass of lung (Williams, 1995: 1630).
2.2 Internal and External Respiration
Respiration is a combination of physiological processes in which oxygen is inhaled and carbon dioxide released by cells in the body. This is an important process of gas exchange. Respiration is divided into two phases. The first phase of external expiratory in the same sense with breathing. It is a combination of movement and skeletal muscle, where the air for the first time pushed into the lungs and then removed. These events include the inspiration and expiration. Phase to another is internal respiration which includes transfer / movement of the molecules of the respiratory gases (oxygen and carbon dioxide) through the membrane, fluid displacement, and the cells of the body as needed.
2.3 Respiratory Organs
Respiratory tract include: (a) nasal cavity (b) of the larynx (c) trachea (d) bronchi (e) lung and (f) pleura. Pharynx has two functions: to the respiratory system and digestive system. Some of the muscles involved in breathing process. The diaphragm is the most important respiratory muscle in addition to the internal and external muscular intercostalis some other muscles.