Ogata J, Minami K, Oishi M, Mekata K, Nishimura M, Sata T
Division of Anesthesia, Ehime Rousai Hospital, Niihama.
Masui. 2000 Oct;49(10):1139-41.
A 40-year-old woman was scheduled for abdominal hysterectomy. Moderate difficulty in tracheal intubation was expected on preoperative evaluation. A size 3 laryngeal mask airway (LMA) was inserted after the induction of general anesthesia. The LMA insertion was accomplished smoothly at the first attempt and there was no air leakage during manual ventilation. Soon after the insertion, acute swellings were noted in the bilateral submandibular triangle regions. Enlargement and deformity of the submandibular glands were diagnosed by ultrasonography. The enlargements increased with elevated pressure of the LMA cuff, but disappeared completely in five minutes after removal of the LMA. Such enlargement did not occur with subsequent tracheal intubation. The patient had an uneventful postoperative course without any residual sequelae. We should pay attention to possible submandibular gland swelling by LMA insertion.
一名40岁女性计划接受腹式子宫切除术。术前评估预计气管插管有中度困难。全身麻醉诱导后插入了一个3号喉罩气道(LMA)。首次尝试时LMA插入顺利,手动通气时无漏气。插入后不久,双侧下颌下三角区出现急性肿胀。超声检查诊断为下颌下腺肿大和畸形。肿大随着LMA套囊压力升高而加重,但在移除LMA后5分钟内完全消失。随后气管插管时未出现这种肿大。患者术后过程顺利,无任何残留后遗症。我们应注意LMA插入可能导致的下颌下腺肿胀。