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喉激光手术麻醉期间易燃气管导管的安全使用——1024例报告及文献综述

Safe Use of Flammable Endotracheal Tubes During Anesthesia for Laryngeal Laser Surgery-Report of 1024 Cases and a Brief Literature Review.

作者信息

Mohseni Masood, Izadi Farzad

出版信息

Iran J Otorhinolaryngol. 2019 Jul;31(105):225-227.

Abstract

INTRODUCTION

One of the major concerns in laryngeal laser surgery is the risk of airway fire. The introduction ofwrapped tubes and metal tubes has reduced the fire hazards. However, these tubes are expensive and do not provide convenient access to the surgical field. There are few laboratory studies addressing the resistance of polyvinylchloride tubes against ignition in the given circumstances. Nevertheless, its safety should be approved in clinical practices.

MATERIALS AND METHODS

This retrospective studyevaluated the airway management on 1024 patients undergoing laryngeal laser surgery. The data collection included the information about the type of endotracheal tube (ETT), mode of ventilation, and airway hazards (e.g., tube ignition).

RESULTS

Polyvinylchloride tubes and conventional positive pressure ventilation was applied for most of the patients (84.1%). The tube cuff was pierced with laser beam in 22 cases (2.5%). However, there was no case of ETT ignition or airway fire.

CONCLUSION

Polyvinylchloride tubes can be safely used in this subset of surgeries pending meticulous attention to the safety recommendations.

摘要

引言

气道起火风险是喉激光手术中的主要担忧之一。带套囊气管导管和金属气管导管的应用降低了起火风险。然而,这些导管价格昂贵,且不利于进入手术视野。目前鲜有关于聚氯乙烯气管导管在特定情况下抗点燃性的实验室研究。尽管如此,其安全性仍需在临床实践中得到验证。

材料与方法

本回顾性研究评估了1024例行喉激光手术患者的气道管理情况。数据收集包括气管内导管(ETT)类型、通气模式及气道风险(如导管点燃)等信息。

结果

大多数患者(84.1%)使用了聚氯乙烯气管导管及传统正压通气。22例(2.5%)患者的导管套囊被激光束穿透。然而,未发生气管内导管点燃或气道起火的情况。

结论

在严格遵循安全建议的前提下,聚氯乙烯气管导管可安全用于此类手术。

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