Successful Management of Severe Upper Airway Obstruction during Emergence of Anesthesia in Consequence of Fracture of Deflated Laryngeal Mask Airway Due to Biting-A Case Report

催醒過程中咬斷已排氣喉頭罩而造成嚴重呼吸道阻塞之病例報告

張婉玲(Wan-Ling Chang) ； 許淑霞(Shu-Shya Hseu) ； 王超群(Chao-Chun Wang) ； 張正熹(Cheng-Hsi Chang) ； 陳國瀚(Kwok-Han Chan) ； 陳品堂(Pin-Tarng Chen)

《Acta Anaesthesiologica Taiwanica》 45卷1期 (2007/03) Pp. 39-42

摘要

一位健康的17歲女性使用喉頭罩進行全身麻醉並接受拔除前臂內固定手術。手術前並沒有任何呼吸道方面的問題也沒有其他方面的疾病。在麻醉誘導完成後，手術很成功的進行。在手術結束後，病患於催醒過程中，病患維持良好的自發性呼吸，將氣囊排氣後，準備移除喉頭罩時卻咬斷喉頭罩的通氣管而導致嚴重的呼吸道阻塞。本文將討論當病人意識不清且牙關緊閉又遇到斷裂的喉頭罩嚴重阻塞呼吸道時的緊急處置方法。

關鍵字

喉頭罩 ； 呼吸道阻塞

並列摘要

Biting the laryngeal mask airway during general anesthesia in the absence of a bite block as a forestallment is a common but usually uncomplicated event. We report a young healthy adult female patient who underwent removal of fixation implant in the right elbow under general anesthesia, during the emergence of which she bit and severed the airway tube of the laryngeal mask airway (LMA) after cuff deflation and developed upper airway obstruction in consequence of air blockade by the displaced deflated LMA cuff remaining inside the mouth. Removal of residual part of the LMA in the mouth was successful with propofol re-anesthetization without molestation of O2 saturation. We discuss the management of this critical airway condition resulting from fracture of deflated LMA in the closed mouth.

並列關鍵字

Laryngeal masks ； Airway obstruction