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Anesth Analg 2004;98:1807-1808
© 2004 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000117144.16826.61

GENERAL ARTICLES

A Severe Complication After Laser-Induced Damage to a Transtracheal Catheter During Endoscopic Laryngeal Microsurgery

Bettina Leemann, MD*, Thomas Heidegger, MD*, Rudolf Grossenbacher, MD{dagger}, Thomas Schnider, MD*, and Hans J. Gerig, MD*

Departments of *Anesthesiology and {dagger}Ear, Nose, Throat, Head, and Neck Surgery, St. Gallen Cantonal Hospital, St. Gallen, Switzerland

Address correspondence and reprint requests to Bettina Leemann, MD, Department of Anesthesiology, Cantonal Hospital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland. Address e-mail to bettina.leemann{at}kssg.ch

Subcutaneous emphysema and pneumothorax is a rare and severe complication of percutaneous transtracheal jet ventilation, usually caused by obstruction of the upper airway or displacement of the tracheal catheter. Nevertheless, it is our preferred technique for endoscopic laryngeal laser surgery. We report a patient with acute subcutaneous emphysema and pneumothorax during laser surgery, caused by unobserved laser damage and discuss the associated risk factors.

IMPLICATIONS: The percutaneous transtracheal jet ventilation for elective laryngeal laser surgery reduces the risk of airway fires and gives a free endoscopic operative field. This case report suggests that, even when using a teflon catheter, laser-induced damage with severe complications might occur.




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M. B. Sosis, B. Leemann, T. Heidegger, R. Grossenbacher, T. Schnider, and H. J. Gerig
Should CO2 Laser Jet Ventilation Be Abandoned? * Response
Anesth. Analg., December 1, 2004; 99(6): 1882 - 1882.
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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2004 by the International Anesthesia Research Society.