Three-way device for intratracheal administration and application

Abstract

The three-way device comprises an air inlet end A, an air outlet end B, a medicine injection end C, an external air source connector D and an external silicon rubber case E or F. The whole three-way device is of a one-time forming structure, and the total length of a main body A and a main body B of the three-way device is controlled to range from 80 mm to 100 mm. The device is a simple and easy three-way device, the air inlet end A is connected with a breathing loop or simple breathing equipment, the air outlet end B is connected with an airway device of a patient end, and the outer edge of the medicine injection end C is sleeved with the silicon rubber case E so that the device can be used for beta2 receptor stimulant spray; after the silica gel sleeve F is sleeved on the outer edge of the medicine injection end C, an injector can be used for direct medicine injection. The full-closed intratracheal administration mode under a certain pressure is adopted, so that the utilization rate of the medicine is increased, the medicine injection choices are diversified, and aiming at airway spasm caused by different reasons, the onset time of the medicine is shortened, meanwhile, the toxic and side effects of the medicine are reduced to a great extent, and precious time is won for rescue.

Description

Technical Field

[0001] The present invention belongs to the field of medical technology, and relates to a device and application for emergency treatment of bronchospasm, the most serious complication during general anesthesia. Intratracheal administration is a rapid and effective administration method for bronchospasm. Background Art

[0002] Bronchospasm caused by various reasons is one of the serious perianesthetic adverse events during anesthesia that endangers the patient's life safety. The incidence of bronchospasm worldwide is about 1:6000, of which the mortality rate is about 1:250. In a large analysis of medical claims, although bronchospasm only accounts for 2%, 90% of them are accompanied by severe craniocerebral injury or even death. Bronchospasm that needs to be treated during the perianesthetic period is mostly caused by laryngoscopy, endotracheal intubation, airway suction, inhalation of cold air and extubation. This seemingly uncommon adverse event may have catastrophic consequences.

[0003] The pathogenesis of bronchospasm is: the parasympathetic nerve tension is increased due to various reasons, or the non-adrenergic and non-cholinergic nervous systems widely distributed in the lung tissue are activated by some stimulants. In the former, the stimulation directly acts on the afferent fibers of the vagus nerve to activate the vagus nerve and eventually release acetylcholine to act on the M3 cholinergic receptors to directly cause the contraction of bronchial smooth muscle. In the latter, certain pro-inflammatory factors directly stimulate the unmyelinated C fibers of the non-adrenergic and non-cholinergic nervous systems, and directly release neuropeptides through axial reflexes, such as substance P, neurofactors A and B, and peptide substances related to neurofactor genes, which directly lead to the contraction of respiratory smooth muscle.

[0004] Clinically, the rescue drugs for bronchospasm mainly include adrenergic receptor agonists and glucocorticoids. Adrenergic receptor agonists can quickly relax bronchial smooth muscles, and there are two main ways of application: intravenous administration and intratracheal administration. Intravenous administration of adrenergic receptor agonists can reduce bronchial resistance and achieve the effect of bronchodilation, but these drugs will cause varying degrees of hemodynamic fluctuations. Severe hemodynamic fluctuations can affect the perfusion of important organs and tissues, thus restricting their application. In addition to the uncontrollable dosage and easy overdose, direct intratracheal administration also has the potential risk of infection and injury. The main function of glucocorticoids is to reduce tissue edema and inflammatory response.

[0005] In recent years, for bronchospasm caused by asthma, metered-dose inhalation devices have been widely used. There are two main forms, passive inhalation devices and spray devices. The main drugs loaded are fast-acting β2 receptor agonists and glucocorticoids. The most common of the former are salbutamol, levalbuterol and pirbuterol. These drugs take effect within 1-5 minutes, and the peak time is about 1 hour. The latter mainly include beclomethasone, budesonide, fluticasone and triamcinolone.

[0006] Some scholars have proposed to use this device in clinical anesthesia to solve bronchospasm. However, if these drugs are used in patients with spontaneous breathing or patients who can actively inhale, generally 1-3 unit doses can achieve satisfactory results. However, in patients with endotracheal intubation and no spontaneous breathing, it is necessary to disconnect the patient from the breathing circuit when administering the drug, which interrupts the patient's ventilation support. Since there is no airflow to transport the drug to the lungs, bronchi, terminal bronchioles and even alveoli, it has been reported in the literature that patients with endotracheal intubation often need 10-15 unit doses to achieve satisfactory bronchial dilation. Then, the toxic effects or side effects of the drug will also be manifested, mainly muscle fibrillation and tachycardia. These reactions are often fatal to patients in emergency situations. Therefore, to some extent, the application is limited. Summary of the invention

[0007] Bronchospasm during the perianesthetic period is very troublesome. Although intravenous and intratracheal administration of β2 receptor agonists are effective, they have many disadvantages. If a quantitative spray device for the treatment of bronchospasm can be used in such cases, it will not only be effective but also greatly reduce the amount of drugs, thereby reducing drug-related side effects.

[0008] To achieve this goal, the first problem to be solved is to ensure that there is enough airflow during drug administration to carry the drug to the main bronchi, bronchioles and even the terminal airways; secondly, to ensure that there is a certain continuous pressure in the airway during drug administration, the circulation needs to be relatively closed so that there can be appropriate airway pressure to ensure sufficient diffusion of the drug; thirdly, the relative or absolute unidirectionality of the drug administration port must be solved to prevent drug overdose.

[0009] To achieve the above objectives, a simple and easy-to-use three-way device is theoretically needed. The drug delivery port needs to be sealed after being connected to the drug spray device, and should be at a certain angle to achieve a relatively open inhalation drug delivery, while exhalation is relatively closed due to airway pressure.

[0010] To this end, the present invention discloses a three-way device for intratracheal drug administration, which is characterized in that it mainly includes an air inlet end A, an air outlet end B, a drug injection end C, an external air source interface D, and a silicone sleeve installation positioning line M. The overall three-way device is a one-time molding structure to ensure its stability, and the total length of the main body AB of the overall three-way device is controlled between 80-100 mm; wherein The silicone sleeve installation positioning line M is used to determine the installation position of the silicone sleeve, including the external silicone sleeve E or F; The air inlet port A is used to connect to a standard breathing circuit, with an outer diameter D1 of 22 mm and a wall thickness of 2 mm; The outlet B is an internal variable diameter structure with an inner diameter D2 of 16mm and a wall thickness of 3mm to resist deformation of the pipeline caused by airway pressure. It is mainly used to connect standard airway devices (endotracheal tube, laryngeal mask and pressurized mask). The device body AB is a cylinder with a variable diameter design, and the variable diameter range is 16-22mm. The injection end C is a cone of 10-22 mm, with an outer diameter D4 of 22 mm, and the end is cylindrical, the angle between the injection end C and the straight part of the tee body AB is 30-40 degrees, and the interface of the port is located at the middle upper 1 / 3-2 / 3 of the tee body AB, and the outer edge is covered with an external silicone sleeve E or F with an inner diameter D5=22 mm, which is the same height as the cylindrical part of the injection end C, and the edge of the silicone sleeve is aligned with the silicone sleeve installation positioning line M; the external silicone sleeve E is centrally provided with a rectangular window with an opening of 8 mm-14 mm, which is used for the administration of specific β2 agonist drugs, and the external silicone sleeve F is centrally provided with a circular hole with an opening of 1 mm for syringe administration; The external gas source interface D is located at 1 / 3-1 / 4 of the A end of the main body AB of the integral three-way device. Its outer diameter D3=6.5mm is equipped with a one-way valve for emergency oxygen supply when there is no high-pressure oxygen source in the respiratory equipment (ventilator or anesthesia machine).

[0011] The present invention further discloses a method for using the three-way device for intratracheal drug administration, which is performed according to the following steps: First, disconnect the breathing loop, connect the air inlet to the breathing loop, and connect the air outlet to the patient's airway device; Second, according to different situations, select the external silicone sleeve used for different drugs, put it on the cylinder at the outer edge of the injection end and align it with the silicone sleeve installation positioning line, and place the corresponding drug on the silicone sleeve; Third, perform manual ventilation on the patient and close the anesthesia machine's air escape valve or adjust the pressure of the air escape valve to 30-50 cm of water column according to the patient's airway resistance; Fourth, the operator assists the patient in ventilation, and the assistant injects the drug or squeezes the pressure valve at the tail end of the drug nebulizer. After injecting the drug, the operator immediately squeezes the balloon to complete the patient's inhalation process, and uses a fully mixed drug airflow to deliver the drug to the lungs. At the end of inspiration, a certain period of positive pressure is applied to ensure that the drug is fully absorbed. Fifth, if there is no ventilation equipment such as anesthesia machine or ventilator that can use high-pressure air source, the operation method is as follows: 1. Connect the air inlet end of the device to the simple exhaler 2. Connect the air outlet end to the pressurized mask 3. Select the silicone sleeve used for different drugs according to different situations. Install the positioning line of the silicone sleeve on the outer edge of the cylinder and place the corresponding drug on the silicone sleeve 4. Place the pressurized mask on the patient's face. The operator fastens the pressurized mask with both hands, and the assistant operates the simple exhaler and injects the drug at the same time.

[0012] The present invention further discloses the use of a three-way device for intratracheal drug administration for relieving airway spasm; the airway spasm relief refers to the rescue of airway spasm caused by various reasons, and is particularly suitable for anesthesia and surgery. Clinical trials show that the use of the three-way device for intratracheal drug administration of the present invention not only takes effect faster and has a more precise effect, but also has a lower incidence of drug toxicity and side effects and related adverse reactions.

[0013] The present invention is described in more detail as follows: First, since it is connected between the breathing loop and the airway device, the straight part of the tee adopts an internal variable diameter design with an outer diameter of 22mm at the breathing loop end and an inner diameter of 16mm at the airway device section, with a variable diameter range of 16-22mm to resist the deformation of the pipeline caused by airway pressure. It is mainly composed of the air inlet end A, the air outlet end B, and the injection end C. The outer diameter of the C end is 22mm, equipped with a silicone sleeve with an inner diameter of 22mm and a wall thickness of 2mm and different opening specifications to apply various drug delivery devices, among which the silicone sleeve E is a silicone sleeve for the specific β2 receptor agonist salbutamol, and the silicone sleeve F is used for syringe injection.

[0014] Second, for ease of application and portability, the total length is controlled between 80-100 mm.

[0015] Third, the angle between the drug interface and the straight part is 30-40 degrees, and the interface between the port and the main airway is located in the middle and upper 1 / 3 of the main pipeline, so that the substances from the two pipelines can be fully mixed, and the turbulence formed by the intersection of airflows can be minimized. The drug delivery port is designed to be a 10mm to 22mm cone, and its intersection with the tee body is elliptical, and the area is 1 / 3-2 / 3 of the tee body AB. The purpose of this design is to obtain a larger initial velocity when the drug enters the main pipeline, and at the same time, the drug and gas are mixed more fully with a smaller cross-sectional area. It is also equipped with a silicone sleeve, which has three main specifications: fully enclosed, with an opening of 1-3mm for syringe application, and an opening of 14mm and 8mm in a rectangular shape for quantitative spray application. The silicone sleeve can completely seal the injection end C after connecting different types of drug delivery devices. Fourth, an interface for a common oxygen tube is added to facilitate external oxygen supply in the absence of an anesthesia machine or ventilator or other equipment that can be connected to a high-pressure gas source for positive-pressure ventilation.

[0016] Fifth, the purpose of designing a fully enclosed silicone sleeve is: when dealing with emergency airway spasm, intratracheal injection is often done intermittently. During the intervals, the nebulizer may cause the silicone sleeve to fall off due to gravity. In addition, the use of a syringe may also cause iatrogenic needle stick injuries. Therefore, a fully enclosed silicone sleeve can be used during the intervals between injections to prevent the above problems from occurring.

[0017] Compared with the prior art, the three-way device for intratracheal drug administration and its application disclosed in the present invention have the following positive effects: (1) The fully enclosed intratracheal drug administration mode under a certain pressure increases the utilization rate of drugs. The diversified injection options can target airway spasms caused by different reasons. It not only speeds up the onset of drug effects, but also greatly reduces the toxic and side effects of drugs, thus buying precious time for rescue.

[0018] (2) The present invention solves the problem that the rescue of acute airway spasm is mainly carried out in the airway, the effect is uncertain and there are many toxic and side effects. At the same time, the entire airway is in a fully closed state, and the range of drug selection is increased. Clinical trials have shown that compared with the traditional injection method, the application of this three-way drug administration not only has a faster onset and a more accurate effect, but also has a low incidence of adverse reactions related to the toxic and side effects of the drug, and is more effectively applied to patients. BRIEF DESCRIPTION OF THE DRAWINGS

[0019] Figure 1 It is a schematic diagram of the structure of a three-way device for intratracheal drug administration; Figure 2 This is a schematic diagram of the structure of the external silicone sleeve E; Figure 3 This is a schematic diagram of the structure of the external silicone sleeve F; Figure 4 It is a top view of the three-way device for intratracheal drug delivery; wherein A Inlet end, outer diameter D1 is 22mm; B Outlet end, inner diameter D2 is 16mm, C injection end, D4 outer diameter 22mm, D external gas source interface, D3 outer diameter 6.5mm; External silicone sleeve E or F, D5 inner diameter 22mmM silicone sleeve installation positioning line. DETAILED DESCRIPTION

[0020] The present invention is described below by specific embodiments. Unless otherwise specified, the technical means used in the present invention are methods known to those skilled in the art. In addition, the embodiments should be understood as illustrative rather than limiting the scope of the present invention, and the essence and scope of the present invention are limited only by the claims. For those skilled in the art, various changes or modifications made in these embodiments, without departing from the essence and scope of the present invention, also belong to the protection scope of the present invention. Materials and reagents used in the present invention are all commercially available. Example

[0021] A three-way device for intratracheal drug administration, characterized in that it mainly includes an air inlet end A, an air outlet end B, a drug injection end C, an external air source interface D, an external silicone sleeve E or F, and a silicone sleeve installation positioning line M. The overall three-way device is a one-time molding structure to ensure its stability, and the total length of the main body AB of the overall three-way device is controlled at 80 mm; wherein The air inlet A is used to connect to a standard breathing circuit, with an outer diameter D1 of 22 mm and a wall thickness of 2 mm. The air outlet B is an internal variable diameter structure with an inner diameter D2 of 16 mm and a wall thickness of 3 mm to resist deformation of the pipeline caused by airway pressure. It is mainly used to connect standard airway devices (endotracheal tubes).

[0022] The injection end C is a 10mm-22mm cone, with an outer diameter D4 of 22mm, and the end is cylindrical. The angle between the injection end C and the straight part of the tee body AB is 30 degrees, and the interface of the port is located at the middle and upper 1 / 3 of the tee body AB, and the outer edge is covered with an external silicone sleeve E or F with an inner diameter D5=22mm of the same height as the cylindrical part of the injection end C according to the positioning line M. After the outer edge is covered with an external silicone sleeve and connected with the corresponding medicine, the injection end C can be closed. The external gas source interface D is located at 1 / 3 of the main body AB of the overall tee device close to the A end, with an outer diameter D3=6.5mm, and is used for emergency oxygen supply when there is no high-pressure oxygen source. E has a centrally-set rectangular window with a size of 14 mm in length and 8 mm in width, which is used for the administration of specific β2 agonist drugs. The external silicone sleeve F has a centrally-set circular hole with an opening of 1 mm for injection with a standard 10 ml syringe. The external silicone sleeve (E) or (F) has three main spray specifications: fully enclosed, opening 1 for injection with a standard 10 ml syringe, and a rectangular opening of 14 mm and 8 mm for quantitative application. Example

[0023] The method of using the intratracheal drug delivery three-way device of the present invention is as follows: First, disconnect the breathing loop, connect the air inlet A to the breathing loop, and the air outlet B to the patient's airway device; Second, choose a silicone sleeve F and put it on the outer edge of the cylinder at the injection end C, and connect a standard 10ml syringe filled with medicine to the silicone sleeve; Third, perform manual ventilation on the patient and close the anesthesia machine's gas escape valve.

[0024] Fourth, the operator assists the patient with ventilation, and the assistant injects the drug. After the injection, the operator immediately squeezes the balloon to complete the patient's inhalation process, and uses a fully mixed drug airflow to deliver the drug to the lungs, and gives a certain period of positive pressure at the end of inhalation to ensure full absorption of the drug.

[0025] Fifth, if there is no ventilation equipment such as anesthesia machine or ventilator that can use high-pressure air source, the operation method is as follows: 1. Connect the air inlet end of the device to the simple exhaler 2. Connect the air outlet end to the pressurized mask 3. Select the silicone sleeve used for different drugs according to different situations. Install the positioning line of the silicone sleeve on the outer edge of the cylinder and place the corresponding drug on the silicone sleeve 4. Place the pressurized mask on the patient's face. The operator fastens the pressurized mask with both hands, and the assistant operates the simple exhaler and injects the drug at the same time.

[0026] Example 3 (Clinical Application) Case 1 March 11, 2024: Patient basic information: male, 56 years old, height 165cm, weight 55kg, body mass index (BMI): 20.2, hospital number 140312. Medical history: bullae, grade 2 hypertension, taking medication regularly.

[0027] Surgery information: Admission diagnosis: fungal keratitis, planned surgery: full-thickness keratoplasty. Anesthesia method: general anesthesia with laryngeal mask.

[0028] Application: The patient had a sudden airway spasm during the perioperative period, so the operation was stopped. After deepening anesthesia, there was no relief. The B end of the device was connected to the laryngeal mask, the A end was connected to the breathing circuit, and the silicone sleeve E was installed. Salbutamol aerosol was given directly to the airway. After 6 breathing cycles (about 20 seconds), the symptoms were relieved. After the vital signs stabilized, the patient was sent to the post-anesthesia recovery room, where the vital signs were stable, and the patient returned to the ward safely 1 hour later.

[0029] Case 2 April 9, 2024: Patient basic information: male, 19 years old, height 175cm, weight 75kg, BMI: 24.4, hospital number 140761, medical history: none Surgery information: Admission diagnosis: orbital mass, planned surgery: orbital mass removal. Anesthesia: general anesthesia with endotracheal intubation.

[0030] Application: After the operation, the patient was given a skeletal muscle relaxant antagonist. About 20 seconds later, the patient had airway spasm, difficulty in ventilation, rales on auscultation of both lungs, and obvious in both lower lungs. The initial diagnosis was airway spasm caused by drug allergy. Epinephrine 10μg / kg was given intravenously. After 10 seconds, the airway spasm was partially relieved (ventilation was possible, airway peak pressure>30cmH2O), and blood pressure began to rise, and heart rate increased greatly (HR>150bpm). Then the device was connected, the B end was connected to the endotracheal tube, the A end was connected to the breathing circuit, and the silicone sleeve F was installed. Epinephrine 1μg / kg was directly given to the airway. After 10 seconds, ventilation basically returned to normal, and sedatives were given intravenously to deepen anesthesia and stabilize blood flow chemistry. After 10 minutes, the patient's spontaneous breathing was restored, vital signs were stable, and breath sounds were clear on auscultation of both lungs. After the endotracheal tube was removed, the patient was sent to the post-anesthesia recovery room, where vital signs were stable, and he returned to the ward safely after 1 hour.

[0031] Case 3 July 19, 2024: Patient's basic information: female, 3 years and 4 months old, height 109, weight 20kg, BMI: 16.8, hospital number: 141774, past medical history: allergic asthma, maintained by long-term inhaled medication.

[0032] Surgery information: Admission diagnosis: entropion, planned surgery: bilateral entropion correction. Anesthesia: general anesthesia with laryngeal mask.

[0033] Application: The child was given dexmedetomidine nasal drops (0.5 mg / kg) before the operation. After being quiet, he entered the room and brought his own medicine (salbutamol spray). The conventional induction drugs for anesthesia were: propofol 60 mg, sufentanil 4 μg, and the muscle relaxant rocuronium bromide 12 mg was given after the spontaneous breathing was interrupted. A No. 2 laryngeal mask was inserted, and the ventilation was good and the laryngeal mask was fixed. The surgeon disinfected and laid the towel. About 5 minutes after the operation started, the airway pressure suddenly increased and ventilation was impossible. Auscultation of both lungs was rales. It was considered that the surgeon accidentally touched the airway device during the operation, stimulating the airway and causing airway spasm. Then the device was connected, the B end was connected to the laryngeal mask, the A end was connected to the breathing circuit, and the silicone sleeve E was installed. One unit of salbutamol was directly given. After 10 seconds, the ventilation was relieved. 1 unit was added. After 20 seconds, the ventilation was completely relieved. The operation was successfully completed after about 45 minutes. After 6 minutes, the patient's spontaneous breathing was restored, vital signs were stable, and the breath sounds of both lungs were clear. After the endotracheal tube was removed, the patient was sent to the post-anesthesia recovery room, where his vital signs were stable and he returned to the ward safely one hour later.

[0034] Case 4 August 16, 2024 Patient's basic information: female, 42 years old, height 173cm, weight 61.5kg, BMI: 20.1, hospital number: 142446, past medical history, diabetes for 3 years, blood sugar control is good.

[0035] Surgical information: Admission diagnosis: high myopia in both eyes, planned surgery: posterior scleral reinforcement of the left eye, anesthesia method: laryngeal mask general anesthesia.

[0036] Application: The patient underwent a smooth operation, which took about 65 minutes. After the operation, the patient recovered spontaneous breathing, was conscious, had a satisfactory tidal volume, and maintained an exhaled air oxygen saturation of more than 95%. The patient returned to the post-anesthesia recovery room (PACU). After the recovery room, the patient was connected to a monitor and low-flow oxygen inhalation. The NIBP (non-invasive arterial blood pressure) was 112 / 67 mmHg, the HR (heart rate) was 87 beats / min, and the SpO2 (pulse oxygen saturation) was 98%. Six minutes later, the PACU called for emergency help. The patient had difficulty breathing, clear consciousness, obvious whistling sounds on auscultation of both lungs, and SpO2 gradually decreased. Airway spasm was considered, and the patient received oxygen inhalation through a mask and assisted ventilation with a simple respirator. The device was used, with low-pressure oxygen connected to the D port, a simple respirator connected to the A end, and a pressurized mask connected to the B end. The silicone sleeve F was installed, and 60 micrograms of epinephrine were given through the injection port. After two minutes of pressurized assisted ventilation, the dyspnea gradually eased and the SpO2 gradually increased. The dyspnea was completely relieved after 5 minutes. 1After disappearance, the patient's vital signs were stable and he returned to the ward safely.

Claims

1. A three-way device for intratracheal drug delivery, characterized in that It mainly includes an air inlet (A), an air outlet (B), a drug injection end (C), an external air source interface (D), and a silicone sleeve installation positioning line (M); the overall three-way device is a one-time molding structure to ensure its stability, and the total length of the three-way device body AB is controlled between 80-100mm; The silicone sleeve installation positioning line (M) is used to determine the installation position of the silicone sleeve, including the external silicone sleeve (E) or (F); The air inlet (A) is used to connect to a standard breathing circuit, with an outer diameter D1 of 22 mm and a wall thickness of 2 mm. The outlet end (B) is an internal variable diameter structure with a variable diameter range of 16-22mm. Its inner diameter D2 is 16mm and the wall thickness is 3mm to resist the deformation of the pipeline caused by the airway pressure. The main body AB of the three-way device is a cylinder with a variable diameter design, which is mainly used to connect standard airway devices; The injection end (C) is a 10-22mm cone with an outer diameter D4 of 22mm and a cylindrical end. The angle between the injection end (C) and the straight part of the tee body AB is 30-40 degrees, and the port interface is located at the middle and upper 1 / 3-2 / 3 of the tee body AB. The edge of the silicone sleeve is provided with a silicone sleeve installation positioning line (M), and the external silicone sleeve (E) or (F) is provided with an inner diameter D5=22mm with the same height as the cylindrical part of the injection end C; the external silicone sleeve (E) is provided with a rectangular window with an opening of 8mm-14mm in the center for the administration of specific β2 agonist drugs, and the external silicone sleeve (F) is provided with a circular hole with an opening of 1mm in the center for syringe administration; The external gas source interface (D) is located at 1 / 3-1 / 4 of the A end of the main body AB of the integral three-way device. Its outer diameter D3=6.5mm is equipped with a one-way valve for emergency oxygen supply when there is no high-pressure oxygen source for the breathing apparatus.

2. A three-way device for intratracheal drug delivery according to claim 1, characterized in that The airway device used for connecting to the standard refers to: endotracheal tube, laryngeal mask and pressure mask.

3. The three-way device for intratracheal drug administration according to claim 1, characterized in that The external gas source refers to oxygen.

4. A method for using the three-way device for intratracheal drug administration according to claim 1, characterized in that Proceed as follows: First, disconnect the breathing loop, connect the air inlet to the breathing loop, and connect the air outlet to the patient's airway device; Second, according to different situations, select the external silicone sleeve used for different drugs, put it on the cylinder at the outer edge of the injection end and align it with the silicone sleeve installation positioning line, and place the corresponding drug on the silicone sleeve; Third, perform manual ventilation on the patient and close the anesthesia machine's air escape valve or adjust the pressure of the air escape valve to 30-50 cm of water column according to the patient's airway resistance; Fourth, the operator assists the patient in ventilation, and the assistant injects the drug or squeezes the pressure valve at the tail end of the drug nebulizer. After injecting the drug, the operator immediately squeezes the balloon to complete the patient's inhalation process, and uses a fully mixed drug airflow to deliver the drug to the lungs. At the end of inspiration, a certain period of positive pressure is applied to ensure that the drug is fully absorbed. Fifth, if there is no ventilation equipment such as anesthesia machine or ventilator that can use high-pressure air source, the operation method is as follows:

1. Connect the air inlet end of the device to the simple exhaler 2. Connect the air outlet end to the pressurized mask 3. Select the silicone sleeve used for different drugs according to different situations. Install the positioning line of the silicone sleeve on the outer edge of the cylinder and place the corresponding drug on the silicone sleeve 4. Place the pressurized mask on the patient's face. The operator fastens the pressurized mask with both hands, and the assistant operates the simple exhaler and injects the drug at the same time.

5. The use of the method for using the three-way device for intratracheal drug delivery as described in claim 4 for relieving airway spasm; the relieving airway spasm refers to the rescue of airway spasm caused by various reasons, and is particularly suitable for use during anesthesia and surgery.

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