title: [Undetachable connection between a reinforced endotracheal tube and L connector].
abstract: We anesthesiologists sometimes encounter a situation where we difficulty detaching an L connector from an endotracheal tube. However, to our knowledge, there is no paper wich describes complete inability of detaching the connector from the tube. A 33-year-old female patient was scheduled for jaw joint arthroplasty and manipulation of synarthrophysis after the previous intermaxillary fixation. After midazolam and fentanyl administration, the trachea was intubated with a reinforced endotracheal tube (Mallinckrodt Inc., St. Louis, USA) through the right nostril with the aid of a bronchofiberscope. When we tried to move the anesthesia machine, we could not detach the L connector from the endotracheal tube by any means. Furthermore, because a slip-joint is glued to a reinforced endotracheal tube, it was impossible to separate them. The patient had locklaw, and therefore to avoid reintubation, we scraped off the surface of the L connector, and the connector was successfully detached. Although slip-joints of tracheal tubes and L connectors are standardized with JIS and ISO, their connection is not necessarity good due to the difference of makers and/or a tolerance of products. We think that Tracheostomy Wedge (Portex Inc., New Hampshire, USA) is useful for detaching the cconnection.
authors.affiliation: Department of Anesthesiology, Kansai Medical University, Moriguchi 570-8507.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Kunishi
authors.forename: Sakahiro
authors.initials: S
authors.lastname: Ikeda
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Kuremoto
authors.forename: Kouhei
authors.initials: K
authors.lastname: Murao
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Nakao
authors.forename: Koh
authors.initials: K
authors.lastname: Shingu
mesh_terms: D000328:Adult; D001178:Arthroplasty; D004868:Equipment Failure; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D056948:Orthognathic Surgical Procedures