A Case Report of Endotracheal Tube Cuff Herniation During Lumbar Discectomy

Abstract

BACKGROUND AND OBJECTIVE: Damage to the endotracheal tube cuff during general anesthesia can cause ventilatory failure for the patient. The aim of this study is to report structural defect and herniation of the endotracheal tube cuff in a patient undergoing lumbar discectomy in the prone position. CASE REPORT: The patient was a 77-year-old woman who was a candidate for Lumbar discectomy who referred to Kowsar Hospital in Sanandaj for surgery. The patient underwent general anesthesia with a spiral endotracheal tube in the prone position. After 30 minutes of surgery, there were symptoms of increased airway pressure, decreased saturation, and increased carbon dioxide. Postoperative examinations revealed that the patient's endotracheal tube cuff had a hernia which blocked the airway; the problem was resolved and surgery continued. Diagnosis and treatment of this case have important and significant points that are mentioned below. CONCLUSION: Structural defects in the endotracheal tube and its cuff may cause insufficient ventilation of the patient and reduce the delivery of anesthetic gases to the patient. The definitive solution to endotracheal tube cuff defect is replacement, but conservative measures may be used as a temporary solution in some clinical situations. The anesthesia team should be prepared with adequate equipment, programs, and personnel to follow “​Guidelines for Management of the Difficult Airway” developed by the American Society of Anesthesiologists (ASA) in the case of loss of air exchange in the patient.

Keywords

• endotracheal intubation
• endotracheal tube cuff
• airway
• complications.