Tracheostomy Tube Ignition during Microlaryngeal Surgery Using Diode Laser: A Case Report

二極體雷射於喉部顯微手術使用時所導致之氣切管著火：病例報告

王遜模(Hsun-Mo Wang) ； 李家和(Ka-Wo Lee) ； 蔡承靜(Cheng-Jing Tsai) ； 盧奕承(I-Chen Lu) ； 郭文烈(Wen-Rei Kuo)

《The Kaohsiung Journal of Medical Sciences》 22卷4期 (2006/04) Pp. 199-202

摘要

在全身麻醉下，使用雷射從事於喉部顯微內視鏡手術，所導致的氣管內管著火是一種可能導致嚴重後果但不常見的併發症。我們報告一位因氣管插管所導致的真聲帶狹窄病例，在氧氣分率60%的全身麻醉下，使用二極體雷射從事內視鏡披裂軟骨切除手術時，發生氣切管著火。在立即移除麻醉連接管，以及重新置放一個新的氣切管後，完成預計之手術。病人在術後的門診追蹤，並無上呼吸道之副作用產生。較高的氧氣濃度、助燃物的存在，以及狹窄的手術視野是從事二極體雷射喉內視鏡手術之危險因子。

關鍵字

著火 ； 麻醉 ； 併發症 ； 二極體雷射 ； 喉部顯微內視鏡手術

並列摘要

Ignition of the tracheal tube during laser microlaryngeal surgery under general anesthesia is an uncommon complication with potentially serious consequences. We present here a case of a patient with glottic stenosis following endotracheal intubation, who experienced this potentially catastrophic combustion during endoscopic arytenoidectomy, using a diode laser under general anesthesia via 60% FiO2, with an airway fire occurring at the tracheostomy tube and causing tubal damage and obstruction. The anesthetic connecting tube was immediately disconnected and the tracheostomy tube replaced. No adverse consequences to this patient's upper airway were noted during follow-up visits. Higher oxygen concentrations, the presence of combustibles, and the narrowness of the surgical field during endolaryngeal diode laser surgery are risk factors for airway fires.

並列關鍵字

ignition ； anesthesia ； complication ； diode laser ； microlaryngeal surgery