Cargando…

Entrapment of a laryngotracheal topical anesthesia kit during tracheobronchial foreign body removal: a case report

BACKGROUND: In order to reduce the irritation of the airway during tracheobronchial foreign body (TFB) removal, tracheal surface anesthesia is usually performed using a laryngotracheal topical anesthesia (LTA) kit (LTA20, Highgreen Medical Technology Company, China), but difficulty in withdrawing th...

Descripción completa

Detalles Bibliográficos
Autores principales: Zhang, Xi-Yang, Han, Yun, Zhang, Ya-Bing, Liu, Ke-Xuan, Liu, Bin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5984738/
https://www.ncbi.nlm.nih.gov/pubmed/29859048
http://dx.doi.org/10.1186/s12871-018-0529-1
_version_ 1783328653119062016
author Zhang, Xi-Yang
Han, Yun
Zhang, Ya-Bing
Liu, Ke-Xuan
Liu, Bin
author_facet Zhang, Xi-Yang
Han, Yun
Zhang, Ya-Bing
Liu, Ke-Xuan
Liu, Bin
author_sort Zhang, Xi-Yang
collection PubMed
description BACKGROUND: In order to reduce the irritation of the airway during tracheobronchial foreign body (TFB) removal, tracheal surface anesthesia is usually performed using a laryngotracheal topical anesthesia (LTA) kit (LTA20, Highgreen Medical Technology Company, China), but difficulty in withdrawing the LTA kit is rarely reported. We present a case of a difficulty to withdraw the LTA kit due to its entrapment by the movement of a TFB. CASE PRESENTATION: A 1-year-old girl was undergoing TFB removal. After the surgeon completed the tracheal surface anesthesia, the girl suddenly suffered from bucking, leading to the dislodgment of the TFB to the subglottic region, complicating the withdrawal of the LTA applicator. At the same time, the girl’s oxygen saturation (SpO(2)) decreased to 91% and her heart rate dropped from 150 to 100 bpm. Atropine and succinylcholine were administered intravenously immediately, then the surgeon tried to free the TFB by pushing it back into the trachea, after which the LTA applicator was easily withdrawn, and TFB was removed successfully. The girl was discharged from hospital without any complications 2 days later. CONCLUSION: This case report draws our attention to a significant anesthetic clinical consideration during the application of topical anesthesia on the trachea for TFB removal. The possibility of coughing or bucking can lead to migration of the TFB with subsequent airway obstruction, so the depth of anesthesia must be sufficient to prevent harmful reflexes. Also, strong teamwork and good communication are paramount to avoid serious complications.
format Online
Article
Text
id pubmed-5984738
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-59847382018-06-07 Entrapment of a laryngotracheal topical anesthesia kit during tracheobronchial foreign body removal: a case report Zhang, Xi-Yang Han, Yun Zhang, Ya-Bing Liu, Ke-Xuan Liu, Bin BMC Anesthesiol Case Report BACKGROUND: In order to reduce the irritation of the airway during tracheobronchial foreign body (TFB) removal, tracheal surface anesthesia is usually performed using a laryngotracheal topical anesthesia (LTA) kit (LTA20, Highgreen Medical Technology Company, China), but difficulty in withdrawing the LTA kit is rarely reported. We present a case of a difficulty to withdraw the LTA kit due to its entrapment by the movement of a TFB. CASE PRESENTATION: A 1-year-old girl was undergoing TFB removal. After the surgeon completed the tracheal surface anesthesia, the girl suddenly suffered from bucking, leading to the dislodgment of the TFB to the subglottic region, complicating the withdrawal of the LTA applicator. At the same time, the girl’s oxygen saturation (SpO(2)) decreased to 91% and her heart rate dropped from 150 to 100 bpm. Atropine and succinylcholine were administered intravenously immediately, then the surgeon tried to free the TFB by pushing it back into the trachea, after which the LTA applicator was easily withdrawn, and TFB was removed successfully. The girl was discharged from hospital without any complications 2 days later. CONCLUSION: This case report draws our attention to a significant anesthetic clinical consideration during the application of topical anesthesia on the trachea for TFB removal. The possibility of coughing or bucking can lead to migration of the TFB with subsequent airway obstruction, so the depth of anesthesia must be sufficient to prevent harmful reflexes. Also, strong teamwork and good communication are paramount to avoid serious complications. BioMed Central 2018-06-01 /pmc/articles/PMC5984738/ /pubmed/29859048 http://dx.doi.org/10.1186/s12871-018-0529-1 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Zhang, Xi-Yang
Han, Yun
Zhang, Ya-Bing
Liu, Ke-Xuan
Liu, Bin
Entrapment of a laryngotracheal topical anesthesia kit during tracheobronchial foreign body removal: a case report
title Entrapment of a laryngotracheal topical anesthesia kit during tracheobronchial foreign body removal: a case report
title_full Entrapment of a laryngotracheal topical anesthesia kit during tracheobronchial foreign body removal: a case report
title_fullStr Entrapment of a laryngotracheal topical anesthesia kit during tracheobronchial foreign body removal: a case report
title_full_unstemmed Entrapment of a laryngotracheal topical anesthesia kit during tracheobronchial foreign body removal: a case report
title_short Entrapment of a laryngotracheal topical anesthesia kit during tracheobronchial foreign body removal: a case report
title_sort entrapment of a laryngotracheal topical anesthesia kit during tracheobronchial foreign body removal: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5984738/
https://www.ncbi.nlm.nih.gov/pubmed/29859048
http://dx.doi.org/10.1186/s12871-018-0529-1
work_keys_str_mv AT zhangxiyang entrapmentofalaryngotrachealtopicalanesthesiakitduringtracheobronchialforeignbodyremovalacasereport
AT hanyun entrapmentofalaryngotrachealtopicalanesthesiakitduringtracheobronchialforeignbodyremovalacasereport
AT zhangyabing entrapmentofalaryngotrachealtopicalanesthesiakitduringtracheobronchialforeignbodyremovalacasereport
AT liukexuan entrapmentofalaryngotrachealtopicalanesthesiakitduringtracheobronchialforeignbodyremovalacasereport
AT liubin entrapmentofalaryngotrachealtopicalanesthesiakitduringtracheobronchialforeignbodyremovalacasereport