scholarly journals Nasogastric Tube Knotted Around a Nasal Endotracheal Tube in the Nasopharynx: Possible Cause

2021 ◽  
Vol 68 (2) ◽  
pp. 90-93
Author(s):  
Yunosuke Okada ◽  
Hanako Ohke ◽  
Hiroyo Yoshimoto ◽  
Misato Kobashi ◽  
Masato Saitoh ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Endotracheal Tube ◽  
Nasogastric Tube ◽  
Dental Treatment ◽  
Oral Surgery ◽  
Simple Procedure ◽  
Possible Cause

A nasogastric tube is often used along with a nasal endotracheal tube during oral surgery or dental treatment under general anesthesia. Although the insertion of a nasogastric tube is a simple procedure, it can be associated with complications that lead to potentially serious consequences. The knotting of a nasogastric tube around an endotracheal tube is rare. Here, we report a case in which the nasogastric tube became knotted around the nasal endotracheal tube in the nasopharynx. We compare this case with 4 previous similar cases and provide a theory of how the nasogastric tube might have become knotted.

scholarly journals A Case of Successful Tracheal Tube Exchange With McGrath MAC for Tube Damage During Oral Surgery

2020 ◽  
Vol 67 (3) ◽  
pp. 174-176
Author(s):  
Yuko Koyanagi ◽  
Eiko Yokota ◽  
Marina Iwata ◽  
Ritsuko Shimazaki ◽  
Toru Misaki ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Difficult Airway ◽  
Endotracheal Tube ◽  
Oral Surgery ◽  
Maxillary Osteotomy ◽  
Mcgrath Mac ◽  
Lehane Grade ◽  
Tube Exchange ◽  
Nasotracheal Tube ◽  
Grade 3

A patient undergoing a bilateral sagittal split and LeFort 1 maxillary osteotomy performed under general anesthesia required emergent intraoperative exchange of a potentially damaged nasotracheal tube. This exchange was smoothly performed under constant indirect visualization using the McGrath MAC video laryngoscopy system. After the exchange, ventilation of the patient dramatically improved. The removed endotracheal tube was torn 19 cm from the distal tip. The McGrath MAC was useful for visualizing the glottis and confirming the entire course of the tube exchange despite the patient's having a difficult airway (Cormack-Lehane grade 3).

scholarly journals Retropharyngeal Dissection by Parker Flex-Tip Nasal Endotracheal Tube

2017 ◽  
Vol 64 (4) ◽  
pp. 240-243
Author(s):  
Makoto Terumitsu ◽  
Mikiko Hirahara ◽  
Kenji Seo
Keyword(s):  
General Anesthesia ◽  
Endotracheal Tube ◽  
Tracheal Tube ◽  
Dental Treatment ◽  
Nasotracheal Intubation ◽  
Mucosal Injury ◽  
Pharyngeal Mucosa ◽  
Alternative Method

Possible complications of nasotracheal intubation include injury to the nasal or pharyngeal mucosa. Dissection of the retropharyngeal tissue by the endotracheal tube is one of the rarer of the more severe complications. Previous studies have indicated that the Parker Flex-Tip (PFT) tracheal tube (Parker Medical, Highlands Ranch, Colo) reduces the incidence of mucosal injury. We experienced a case involving inadvertent retropharyngeal placement of a PFT tube in a 29-year-old patient during nasotracheal intubation under general anesthesia for elective dental treatment. Despite thermosoftening the PFT tube, expanding the nasal meatus, and ensuring gentle maneuvering, the tube intruded into the left retropharyngeal mucosa. However, the injury was not severe, and the only required treatment was the administration of antibiotics and corticosteroids. Even when a PFT tube is utilized, pharyngeal dissection is possible. When resistance is felt during passing of the PFT tube through the nasopharynx, an alternative method to overcome this resistance should be utilized.

scholarly journals Inter-center comparison of EasyTube and endotracheal tube during general anesthesia in minor elective surgery

PLoS ONE ◽  
2017 ◽  
Vol 12 (6) ◽  
pp. e0178756 ◽  
Author(s):  
Oliver Robak ◽  
Sonia Vaida ◽  
Mostafa Somri ◽  
Luis Gaitini ◽  
Lisa Füreder ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Endotracheal Tube ◽  
Elective Surgery

General Anesthesia in Dentistry and Oral Surgery

1944 ◽  
Vol 5 (3) ◽  
pp. 321-322
Author(s):  
J. G. ARROWOOD
Keyword(s):  
General Anesthesia ◽  
Oral Surgery

scholarly journals CIRURGIAS ORAIS EM PACIENTES EM USO DE VARFARINA: REVISÃO DE LITERATURA

2016 ◽  
Vol 7 (2) ◽  
Author(s):  
Marlus Da Silva Pedrosa ◽  
Jézlia Chris Da Silva Galdino ◽  
Flávia Ennes Dourado Ferro ◽  
José Guilherme Férrer Pompeu ◽  
Marcia Socorro da Costa Borba
Keyword(s):  
Drug Therapy ◽  
Anticoagulant Therapy ◽  
Dental Treatment ◽  
Oral Surgery ◽  
Thromboembolic Events ◽  
Risk Of Bleeding ◽  
Dental Procedures ◽  
Therapy Interruption ◽  
Anticoagulant Drug ◽  
Dental Offices

Introduction: Dental treatment performed in patients on anticoagulant drug therapy is becoming increasingly common in dental offices. Thus, questions concerning thromboembolic and bleeding risks relative to invasive dental procedures, are frequently raised. Aim: To review the scientific evidences regarding anticoagulant therapy interruption in patients taking warfarin undergoing oral surgeries. Methods: It was carried out a literature review in the electronic SciELO, PubMed, Lilacs and Oviatt Library databases from January to March of 2016, using as descriptors: Anticoagulants, Warfarin, Oral Surgery, and Oral Hemorrhage. Results and Discussion: Anticoagulant therapy is extremely important in patients at high risk for development of thromboembolic events. Most studies show that the risk of bleeding oral surgery in patients taking warfarin is relatively insignificant and it can be controlled by simple measures such as hemostasis. Conclusion: It is highly recommended to not interrupt anticoagulant in minor oral surgeries.

scholarly journals Observational Analysis of Changes in Endotracheal Tube Cuff Pressure During Laparoscopic Surgery

2020 ◽  
Vol 3 (2) ◽  
pp. 46-49
Author(s):  
Hunsehalli Revanasiddappa Narendra ◽  
Aparna Nerurkar ◽  
Shibu Sasidharan
Keyword(s):  
Laparoscopic Surgery ◽  
General Anesthesia ◽  
Endotracheal Tube ◽  
Airway Pressure ◽  
Cuff Pressure ◽  
Pressure Gauge ◽  
Endotracheal Tube Cuff ◽  
Tube Cuff ◽  
Observational Analysis ◽  
Endotracheal Tube Cuff Pressure

ABSTRACT Background Laparoscopic surgery is performed under general anesthesia with mechanical ventilation, and a high-volume, low-pressure endotracheal tube (ETT) with a sealing cuff pressure about 20–30 cm of H2O is commonly used for a proper seal and avoidance of overinflation. Nitrous oxide (N2O) is an inhalational anesthetic that is used with oxygen in the ratio 50:50 for the maintenance of anesthesia if there is no facility of medical air. However, N2O increases the intracuff pressure of the tracheal tube due to diffusion of N2O in to cuff during general anesthesia. The present research was done to study the cuff pressure changes during laparoscopic surgeries with N2O anesthesia and to assess its variation during the various stages of surgery and also its correlation with position of the patient. Materials and methods A study was done in a tertiary-level hospital over a period of 1 year in 70 patients undergoing laparoscopic surgery. Endotracheal tube was inflated with incremental doses of 0.5 mL of air to a point where no leak on auscultation on the suprasternal area was noted. Cuff pressure measurement using cuff pressure monitor (Hand pressure gauge) was done at the time of first inflation of cuff up to 20–30 cm of H2O and airway pressure, along with total amount of air inflated was noted as “zero” reading. Thereafter, cuff pressure was measured at regular interval of 5 minutes. Cuff pressures and airway pressures were taken just prior to insufflation, 2 minutes after abdominal insufflation, thereafter every 15 minutes throughout surgery, and 2 minutes after desufflation and prior to extubation. Results Out of 70 patients, maximum patients were of the age-group of 20–50 years (78.5%). There was no statistically significant difference between the groups. Cuff pressure at the induction was kept in range of 20–30 cm of H2O. In this study, mean tracheal cuff pressure at baseline was 21.10 + 6.16 (p value of 0.207) and prior to insufflation was 21 + 7.13 (p value of 0.733). The cuff pressures at 2 minutes post insufflation (P2), P15, P30, P45, and P60 were 31.40 ± 12.54 cm of H2O, 25.79 ± 8.68 cm of H2O, 24.61 ± 7.37 cm of H2O, 23.83 ± 9.43 cm of H2O, and 24.63 ± 4.77 cm of H2O, respectively. p value was strongly significant showing a positive correlation between pneumo-peritoneum and cuff pressures. We could see the cuff pressure continuously increasing in successive readings. Post desufflation and prior to extubation, there was a fall in cuff pressure with mean cuff pressure being 17.24 + 5.32 cm of H2O and 15.27 + 4.00 cm of H2O, respectively, which also suggests that cuff pressures increased with pneumoperitoneum. Conclusion Use of N2O increases the cuff pressure (31.4 + 12.54 cm of H2O), especially immediately post-insufflation (35.54 + 12.06 cm of H2O), more so in head low position (36.28 + 12.13 cm of H2O). Mean airway pressure (Ppeak) also increased with pneumoperitoneum (22.60 + 4.38 cm of H2O). The regular monitoring of endotracheal tube cuff pressure should be a part of regular safe practice of anesthesia, and use of handy device like hand pressure gauge should be implemented in regular practice where N2O is used. How to cite this article Narendra HR, Nerurkar A, Sasidharan S. Observational Analysis of Changes in Endotracheal Tube Cuff Pressure During Laparoscopic Surgery. J Med Acad 2020;3(2):46–49.

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