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双腔支气管插管意外困难拔管:1 例报告。

Unexpected difficult extubation of double lumen bronchial intubation: a case report.

机构信息

Department of Anesthesiology, Ningbo City First Hospital, No. 59 Liuting Street, Haishu District, Ningbo, Zhejiang, China.

出版信息

BMC Anesthesiol. 2021 Dec 10;21(1):311. doi: 10.1186/s12871-021-01512-5.

Abstract

BACKGROUND

The anesthetist and other members of the perioperative team need to be extremely cautious for successful completion of any surgery. If the final step of any general anesthetic-extubation is not sufficiently well planned, it can lead to critical airway incidents during the extubation and hinder transportation of the patient to the post-anesthesia care unit.

CASE PRESENTATION

A 48-year-old female underwent video-assisted thoracoscopic surgery (VATS) combined with left lower lobectomy. The distal end of the left branch of the tracheal tube was lodged by surgical sutures. In this case, the respiratory physician burned the sutures using an argon electrode, after discussion with the thoracic surgery experts.

CONCLUSIONS

Teamwork is essential when caring for a patient with a shared airway. The anesthetist and surgeon must communicate well with each other to achieve optimal surgical outcomes. Importantly, testing the patency of the ETT prior to extubation should be a regular procedure, which is practical significance to guide safe extubation.

摘要

背景

麻醉师和其他围手术期团队成员需要非常谨慎,才能成功完成任何手术。如果全身麻醉的最后一步——拔管没有得到充分的妥善计划,可能会导致拔管期间出现严重气道事件,并阻碍患者转运至麻醉后恢复室。

病例介绍

一名 48 岁女性患者接受了电视辅助胸腔镜手术(VATS)联合左肺下叶切除术。气管导管的左支气管分支的末端被手术缝线卡住了。在这种情况下,呼吸科医生在与胸外科专家讨论后,使用氩电极灼烧缝线。

结论

在共同气道患者的护理中,团队合作至关重要。麻醉师和外科医生必须相互之间进行良好的沟通,以达到最佳的手术效果。重要的是,在拔管前应常规测试 ETT 的通畅性,这对指导安全拔管具有实际意义。

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