一例麻醉法国斗牛犬滞留气管导管的取出：手法喉稳定与神经肌肉阻滞及后续并发症

文献信息

中文摘要

一只5岁雌性已绝育法国斗牛犬在麻醉状态下就诊，气管导管（ETT）滞留于喉部。气囊充气和放气、涂抹润滑剂、旋转ETT以及反复牵拉均未能取出ETT。在神经肌肉阻滞和手法喉稳定下成功取出ETT：左手拇指经口内按压会厌，左手食指和中指从外部夹持喉部以固定喉部。右手对ETT施加牵引力，随后即可将其拔出。该犬在麻醉苏醒时出现喉部梗阻，怀疑为暂时性喉麻痹。该犬使用气管造口管管理3天，恢复良好。4周后，该犬因气管狭窄出现呼吸窘迫，经气管切除吻合术成功治疗。本病例报告描述了使用神经肌肉阻滞和手法喉稳定取出滞留ETT，并对后续并发症进行了反思。

英文摘要

A 5-year-old, female neutered French Bulldog presented under anaesthesia with an endotracheal tube (ETT) lodged in the larynx. Cuff inflation and deflation, application of lubricant, ETT rotation, and repeated traction did not allow ETT removal. The ETT was successfully removed under neuromuscular blockade with manual laryngeal stabilisation: the left thumb pressed against the epiglottis intraorally and the left index and middle fingers gripped the larynx externally to immobilise the larynx. The right-hand applied traction to the ETT, which could then be extracted. The dog's larynx obstructed on recovery from anaesthesia with suspected temporary laryngeal paralysis. The dog was managed with a tracheostomy tube for 3 days and made a good recovery. The dog presented in respiratory distress 4 weeks later with tracheal stenosis that was successfully treated with tracheal resection and anastomosis. This case report describes the use of neuromuscular blockade and manual laryngeal stabilisation to remove a lodged ETT and reflects on the subsequent complications.