title: [Obstruction of an reinforced endotracheal tube due to dissection of internal tube wall during total intravenous anesthesia].
abstract: We report here a case of obstruction of an reinforced endotracheal tube during laryngomicrosurgery under total intravenous anesthesia. In this case, we used a 6.0 mm ID reinforced endotracheal tube that had been used previously for other patients and sterilized two times by ethylene oxide gas. During the operation, the peak airway pressure increased gradually and eventually reached to 35 cmH2O. After the exchange of the endotracheal tube, ventilation was improved immediately. The endotracheal tube was occluded by dissection of internal wall. Several cases of reinforced tube obstruction have already been reported and in most of these cases the obstruction was related to their repeated use and nitrous oxide anesthesia. However, the present case showed that dissection of reinforced endotracheal tube could also occur during general anesthesia without using nitrous oxide. We should bear in mind that repeated use of reinforced endotracheal tube could induce a critical airway obstruction.
authors.affiliation: Department of Anesthesiology, University of Hirosaki School of Medicine, Hirosaki 036-8562.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Tose
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kubota
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Hirota
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Sakai
authors.forename: Hironori
authors.initials: H
authors.lastname: Ishihara
authors.forename: Akitomo
authors.initials: A
authors.lastname: Matsuki
mesh_terms: D000402:Airway Obstruction / Q000209:etiology*; D000771:Anesthesia, Intravenous; D004868:Equipment Failure; D017743:Equipment Reuse; D005027:Ethylene Oxide; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000295:instrumentation*; D008866:Microsurgery; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures; D013242:Sterilization
chemical_list: D005027:Ethylene Oxide