使用硅胶材质气管内导管时出现通气障碍。

Inability to ventilate while using a silicone-based endotracheal tube.

作者信息

Gleich Stephen J, Nicholson Wayne T, Jacobs Travis M, Hofer Roger E, Sprung Juraj

机构信息

Department of Anesthesiology, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA.

出版信息

J Clin Anesth. 2008 Aug;20(5):389-392. doi: 10.1016/j.jclinane.2008.03.008.

DOI:10.1016/j.jclinane.2008.03.008

PMID:18761252

Abstract

We present a complication associated with herniation of a specially designed silicone-based endotracheal tube (ETT) cuff used for laryngeal nerve monitoring (electromyographic [EMG] ETT). Lung ventilation in our patient was initially unimpeded. However, 30 minutes after initiation of anesthesia with desflurane and nitrous oxide, there was a sudden inability to ventilate due to the herniation of the ETT cuff presumably caused by diffusion of nitrous oxide into the silicone-based cuff. In vitro testing has shown that the increase in intracuff pressure during ventilation with nitrous oxide in the silicone-based EMG ETT is much greater (approximately 50 mmHg) than that in the polyvinyl chloride-based ETT (approximately 10 mmHg) routinely used in our department.

摘要

我们报告了一例与用于喉返神经监测（肌电图[EMG]气管内导管）的特殊设计的硅基气管内导管（ETT）套囊疝出相关的并发症。我们患者的肺通气最初未受阻碍。然而，在使用地氟烷和氧化亚氮开始麻醉30分钟后，由于ETT套囊疝出，突然无法通气，推测这是由氧化亚氮扩散到硅基套囊中引起的。体外测试表明，在我们科室常规使用的基于聚氯乙烯的ETT（约10 mmHg）中，使用氧化亚氮通气时，硅基EMG ETT套囊内压力的升高要大得多（约50 mmHg）。