Journal of Dental Anesthesia and Pain Medicine

  • 제23권1호
  • /
  • Pages.39-43
  • /
  • 2023
  • /
  • 2383-9309(pISSN)
  • /
  • 2383-9317(eISSN)
대한치과마취과학회 (The Korean Dental Society of Anesthsiology)
권호 표지
DOI QR코드

DOI QR Code

Air leakage due to the cuff hanging on the vocal cords during nasotracheal intubation: a case report

  • Seung-Hwa Ryoo (Department of Dental Anesthesiology, Seoul National University, School of Dentistry) ;
  • Myong-Hwan Karm (Department of Dental Anesthesiology, Seoul National University, School of Dentistry) ;
  • Se-Ung Park (Department of Dental Anesthesiology, Seoul National University Dental Hospital) ;
  • Hyun Jeong Kim (Department of Dental Anesthesiology, Seoul National University, School of Dentistry) ;
  • Kwang-Suk Seo (Department of Dental Anesthesiology, Seoul National University, School of Dentistry)
  • 투고 : 2022.12.24
  • 심사 : 2023.01.24
  • 발행 : 2023.02.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Nasotracheal intubation is commonly performed under general anesthesia in oral and maxillofacial surgery. For the convenience of surgery, nasal Ring-Adair-Elwyn (RAE) tubes are mainly used. Because the nasal RAE tubes were bent in an "L" shape, the insertion depth was limited. Particularly, it is necessary to accurately determine the appropriate depth of the RAE tubes in children. Several types of nasal RAE tubes are used in the medical market, which vary in material and length. We performed endotracheal intubation using a nasal RAE tube for double-jaw surgery, but air leakage persisted even when the air pressure in the cuff was increased. When checked with a laryngoscope, it was confirmed that the tube was pushed out, and the cuff was caught on the vocal cords, causing air leakage. Since inserting the tube deeply did not solve the problem, replacing it with a nasal RAE tube (PolarTM, Preformed Tracheal Tube, Smith Medical, Inc., USA) did not cause air leakage; thus, we reported this case.

키워드

참고문헌

  1. Hall CE, Shutt LE. Nasotracheal intubation for head and neck surgery. Anaesthesia 2003; 58: 249-56.  https://doi.org/10.1046/j.1365-2044.2003.03034.x
  2. Hunyady AI, Jonmarker C. Are preformed endotracheal tubes appropriately designed for pediatric patients? Paediatr Anaesth 2015; 25: 929-35.  https://doi.org/10.1111/pan.12691
  3. Mort TC, Braffett BH. Conventional versus video laryngoscopy for tracheal tube exchange: Glottic visualization, success rates, complications, and rescue alternatives in the high-risk difficult airway patient. Anesth Analg 2015; 121: 440-8.  https://doi.org/10.1213/ANE.0000000000000825
  4. El-Orbany M, Salem MR. Endotracheal tube cuff leaks: Causes, consequences, and management. Anesth Analg 2013; 117: 428-34.  https://doi.org/10.1213/ANE.0b013e318292ee21
  5. Cherng CH, Wong CS, Hsu CH, Ho ST. Airway length in adults: estimation of the optimal endotracheal tube length for orotracheal intubation. J Clin Anesth 2002; 14: 271-4.  https://doi.org/10.1016/S0952-8180(02)00355-0
  6. Cavo JW Jr. True vocal cord paralysis following intubation. Laryngoscope 1985; 95: 1352-9.  https://doi.org/10.1288/00005537-198511000-00012
  7. Hartrey R, Kestin IG. Movement of oral and nasal tracheal tubes as a result of changes in head and neck position. Anaesthesia 1995; 50: 682-7.  https://doi.org/10.1111/j.1365-2044.1995.tb06093.x
  8. Kim HY, Kim EJ, Shin CS, Kim J. Shallow nasal RAE tube depth after head and neck surgery: association with preoperative and intraoperative factors. J Anesth 2019; 33: 118-24.  https://doi.org/10.1007/s00540-018-2595-4
  9. Rolfe PM, Barker GL. Short nasal tracheal tubes. Anaesthesia 2001; 56: 1011-2. https://doi.org/10.1111/j.1365-2044.2001.2279-15.x