전신마취 중 발생한 우발적 표시풍선 분리의 효과적 해결 -증례 보고- |
임형선ㆍ손지선ㆍ최현호ㆍ김덕규ㆍ이정우ㆍ고성훈 |
전북대학교 의학전문대학원 마취통증의학교실 |
Effective Management for Incidental Detachment of the Pilot Balloon on the Endotracheal Tube: A Case Report |
Hyungsun Lim, Ji Seon Son, Hyun Ho Choi, Deokkyu Kim, Jeong Woo Lee, Seonghoon Ko |
Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School, Jeonju, Korea. sjs6803@chonbuk.ac.kr |
|
|
|
ABSTRACT |
A 57-year-old female with lumbar spinal stenosis at L4-S1 was scheduled to undergo posterolateral interbody fusion.
Intubation with a 7.0 size ID cuffed reinforced tracheal tube (Mallinckrodt(TM), Mallinckrodt Medical Atholen, Ireland) was uncomplicated, and any air leakage was not detected at that time. Two hours after the start of operation, an air leak was apparent at the trachea during ventilation in the prone position. Closer inspection of the inflation tube and pilot balloon showed that the pilot balloon had become detached. Because she was being operated on in the prone position, and ventilation was only possible at a less than optimal state, we attempted to fix this without having to reintubate the patient's trachea. Our solution involved inserting a 21-gauge needle into the inflation tube and a handheld aneroid manometer was then connected to it. The tube cuff was thereafter inflated up to a pressure of 20 cmH2O. In conclusion, careful manipulation is recommended when performing intubation and a needle connector may help secure the airway if the pilot balloon becomes detached during the procedure. |
Key Words:
intubation; needles; trachea |
|
|
|