Ryoo Seung-Hwa, Karm Myong-Hwan, Park Se-Ung, Kim Hyun Jeong, Seo Kwang-Suk
Department of Dental Anesthesiology, Seoul National University, School of Dentistry, Seoul, Korea.
Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Korea.
J Dent Anesth Pain Med. 2023 Feb;23(1):39-43. doi: 10.17245/jdapm.2023.23.1.39. Epub 2023 Jan 30.
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 (Polar™, Preformed Tracheal Tube, Smith Medical, Inc., USA) did not cause air leakage; thus, we reported this case.
鼻气管插管通常在口腔颌面外科手术的全身麻醉下进行。为了手术方便，主要使用鼻环-阿代尔-埃尔温（RAE）管。由于鼻RAE管呈“L”形弯曲，插入深度有限。特别是，准确确定儿童RAE管的合适深度很有必要。医疗市场上使用几种类型的鼻RAE管，其材料和长度各不相同。我们在双颌手术中使用鼻RAE管进行气管插管，但即使增加袖带内的气压，仍存在漏气现象。用喉镜检查时，证实管子被推出，袖带卡在声带处，导致漏气。由于将管子插深并不能解决问题，更换为鼻RAE管（Polar™，预制气管导管，美国史密斯医疗公司）后未出现漏气；因此，我们报告了此病例。
