scholarly journals Palatopharyngeal wall Perforation during Glidescope® Intubation

2008 ◽  
Vol 36 (6) ◽  
pp. 870-874 ◽  
Author(s):  
W. L. Leong ◽  
Y. Lim ◽  
A. T. H. Sla

We report a case of palatopharyngeal wall perforation during intubation with a GlideScope® laryngoscope. The likely mechanism was advancing and rotating the endotracheal tube against a taut palatopharyngeal fold. This was missed during the initial laryngoscopy, because there is a potential blind-spot in the oropharynx when attention is focused on the GlideScope® monitor. Fortunately, there were no sequelae other than minor bleeding and a mild sore throat and no surgical intervention was necessary. The use of unnecessary force during the endotracheal tube insertion, the use of too large a laryngoscope blade and the use of a rigid stylet could possibly also have been contributory factors to this complication.

1970 ◽  
Vol 5 (1) ◽  
pp. 25-28
Author(s):  
Nadeem Parvez Ali ◽  
Md Tauhid-ul-Mulck ◽  
Mahbub Noor ◽  
Md Torab Mollick ◽  
Masud Ahmed ◽  
...  

A prospective study was carried on 120 patients undergoing surgical operations lasting less than 90 minutes. The incidence of postoperative sore throat, dysphasia and hoarseness of voice with 2% lidocaine (Group L) as endotracheal cuff inflating agent was compared with that with distilled water (Group D) and air (Group A). Seventy two percent of lidocaine group in comparison to 60% distilled water group and 37% air group experienced none of the above complications during the entire study period. Only 5% in lidocaine group had sore throat after 22-24 hours compared to 20% in the distilled water group and 45% in the air group. Twenty three percent complained of dysphasia in both lidocaine and distilled water group after 1-3 hours compared to 45% in air group. After 22-24 hours it completely resolved in lidocaine group compared to 20% persisting in the other two groups. Twenty three percent complained of hoarseness in lidocaine group as compared to 35% and 55% in distilled water and air groups respectively after 1-3 hours. This completely resolved in lidocaine group but persisted in 20% and 45% in the distilled water and air group respectively after 22-24 hours. The results showed an advantage in using lidocaine as an endotracheal tube cuff inflating agent in reducing postoperative sore throat, dysphasia and hoarseness in comparison to distilled water and air. Key Words: Lidocain, Endotracheal tube (ETT) cuff inflating agent.   doi: 10.3329/jafmc.v5i1.2847 JAFMC Bangladesh. Vol 5, No 1 (June) 2009 pp.25-28


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Erol Karaaslan ◽  
Sedat Akbas ◽  
Ahmet Selim Ozkan ◽  
Cemil Colak ◽  
Zekine Begec

Abstract Background There are doubts among anesthesiologists on the use of the Laryngeal Mask Airway (LMA) in nasal surgeries because of concerns about the occurrence of blood leakages to the airway. We hypothesized that the use of LMA-Supreme (LMA-S) in nasal surgery is comparable with endotracheal tube (ETT) according to airway protection against blood leakage through the fiberoptic bronchoscopy, oropharyngeal leakage pressure (OLP), heart rate (HR), mean arterial pressure (MAP), and postoperative adverse events. Methods The present study was conducted in a prospective, randomized, single-blind, controlled manner on 80 patients, who underwent septoplasty procedures under general anesthesia, after dividing them randomly into two groups according to the device used (LMA-S or ETT). The presence of blood in the airway (glottis/trachea, distal trachea) was analyzed with the fiberoptic bronchoscope and a four-point scale. Both groups were evaluated for OLP; HR; MAP; postoperative sore throat, nausea, and vomiting; dysphagia; and dysphonia. Results In the fiberoptic evaluation of the airway postoperatively, less blood leakage was detected in both anatomic areas in the LMA-S group than in the ETT group (glottis/trachea, p = 0.004; distal trachea, p = 0.034). Sore throat was detected less frequently in the LMA-S group at a significant level in the 2nd, 6th, and 12th hours of postoperative period; however, other adverse events were similar in both groups. Hemodynamic parameters were not different between the two groups. Conclusion The present findings demonstrate that the LMA-S provided more effective airway protection than the ETT in preventing blood leakage in the septoplasty procedures. We believe that the LMA-S can be used safely and as an alternative to the ETT in septoplasty cases. Trial registration This trial is registered at the US National Institutes of Health (ClinicalTrials.gov) # NCT03903679 on April 5, 2019.


2021 ◽  

ackground/Purpose: Endotracheal tube (ETT)-related sore throat is a common source of stress in intensive care. Quantitative studies on therapy for ETT-related sore throat remain limited. The current study evaluated the therapeutic effects of oral acetaminophen (ACT) and lidocaine (LIDO) spray on pain relief for ETT-related sore throat in intensive care. Methods: Patients who could communicate with caregivers non-verbally and who had acquired ETT-related sore throat at a medical intensive care unit (ICU) were enrolled. The medications were dispensed at the request of the patients. The intensity of ETT-related throat pain was recorded for quantitative comparison before and after patients received 500 mg of ACT orally or one dose of 10% LIDO spray locally. Before leaving the ICU, the patients were interviewed by a research nurse to assess the effect of these interventions on satisfaction with pain management for ETT-related sore throat. Results: We enrolled 89 patients during the study period, and the intensity of ETT-related throat pain significantly decreased after treatment (6.97 in 5 min before vs. 3.60 in 120 min after oral ACT, P < 0.001; 8.56 in 5 min before vs. 4.12 in 120 min after LIDO application, P < 0.001). The degree of pain reduction over time differed between the ACT and LIDO groups. Patients in the LIDO group made more requests for additional therapy compared with patients in the ACT group (1 LIDO spray per request for an average of 4.7 requests vs. 1 ACT dose per request for an average of 1.3 requests, P < 0.001). Patients in both the ACT and LIDO groups reported high satisfaction with pain management for ETT-related sore throat (87.3 of 100 vs. 86.5 of 100, respectively, P = 0.805). Conclusion: ACT and LIDO treatment can effectively attenuate ETT-related sore throat. Patients were highly satisfied with pain management for ETT-related sore throat after both oral ACT and local LIDO application.


PLoS ONE ◽  
2013 ◽  
Vol 8 (10) ◽  
pp. e74467 ◽  
Author(s):  
Baoji Hu ◽  
Rui Bao ◽  
Xiaolin Wang ◽  
Shanshan Liu ◽  
Tianzhu Tao ◽  
...  

2020 ◽  
Author(s):  
Jin Hee Ahn ◽  
Jiseon Jeong ◽  
Se Hee Kang ◽  
Ji Eun Yeon ◽  
Eun A Cho ◽  
...  

Abstract Background Supraglottic airway (SGA) devices do not definitively protect the airway from regurgitation of gastric contents. Increased gastric pressure and long operation time are associated with development of complications such as aspiration pneumonia. The aim of this study was to compare intra-gastric pressure between second-generation SGA and endotracheal tube (ETT) devices during long-duration laparoscopic hepatectomy.Methods A total of 66 patients was randomly assigned to two groups; 33 patients each in the ETT and SGA groups. Intra-gastric pressure was continuously measured via a gastric drainage tube with a three-way stopcock connected to the pressure monitoring device. Normal saline was added to the end of the gastric drainage tube at each operation time point.Results Intra-gastric pressure during pneumoperitoneum was no different between the two groups (p = 0.146) or over time (p = 0.094). The mean (SD) pH of the SGA tip measured after operation was 6.7 (0.4), and a pH less than 4 was not observed. Relative risk of postoperative complications was significantly higher in the ETT group relative to the SGA group (sore throat, 5.5; cough,13.0).Conclusions Use of SGA devices does not further increase intra-gastric pressure, even during prolonged upper abdominal laparoscopic surgery. Also, the frequency of postoperative sore throat and cough was significantly lower when the second-generation SGA device was used.Clinical trial registration of Korea (https://cris.nih.go.kr/cris/index.jsp): KCT0003512 Principle investigator: G S K; date of registration February 15, 2019, https://cris.nih.go.kr/cris).


Author(s):  
Basheer N. K. ◽  
Jaya C. ◽  
Sabir V. T.

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Epistaxis is the most common otorhinolaryngological emergency worldwide. Minor bleeding episodes occur more frequently in children and adolescents, whereas severe bleed requiring otolaryngologic intervention often occur in older individuals. Treatment options can be conservative or surgical, the selection of which should be made considering the parameters: efficiency, complications, and cost-benefit. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This was a prospective study done in 131 patients with epistaxis, in the Department of ENT, Government Medical College, Trivandrum, with the aim to determine the etiology and the outcome of the conservative and surgical management.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The most common causes of epistaxis were trauma and hypertension. The age incidence increased after forty years and majority had unilateral, anterior nasal, mild-moderate bleed. 79% of the cases were managed by conservative measures as opposed to only 21% who required surgical intervention. Success rate of anterior nasal pack and cauterisation of bleeding point was nearly 84%. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Majority of cases of epistaxis can be successfully managed by conservative measures and surgical intervention may not be necessary in most cases. Cauterization of bleeding point is the best conservative method which can be offered to the patient though anterior nasal packing still remains the most preferred method to control the bleed. The most common causes of epistaxis being trauma and hypertension, reducing road traffic accidents and lifestyle illness can reduce the incidence of nasal bleed.</span></p>


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