Anesth Pain Med.  2008 Jan;3(1):67-70.

Airway Obstruction due to Huge Dried Mucous Plug Discovered during Induction of Anesthesia : A case report

• Lee HJ
• Moon SH
• Jeon SS
• Lim YH
• Chon JY

Abstract

Endotracheal obstruction may cause serious complications, including cardiovascular instability, pneumothorax, pulmonary edema and even brain death. A 21-year-old man was scheduled to undergo an open reduction for an orbital fracture. The patient had tracheostomy with an 8.0 mm tracheostomy tube 3 weeks ago and was breathing well spontaneously. When the cuff of tracheostomy tube was inflated for assisted manual ventilation and the induction of anesthesia, signs of partial endotracheal obstruction were observed, including high airway pressure, low tidal volume and high ETCO2. Large dried mucous plug was impacted in the tracheostomy tube. After removing this plug with a sterile surgical forcep, effective ventilation was recovered without complications. The case like this nearly fatal obstruction by large dried mucous plug was rarely reported, but it should be considered cautiously when a patient uses tracheostomy tube as an airway before general anesthesia.

Keyword

airway obstruction; anesthesia induction; mucous plug

MeSH Terms

Airway Obstruction
Anesthesia
Anesthesia, General
Brain Death
Humans
Orbital Fractures
Pneumothorax
Pulmonary Edema
Respiration
Surgical Instruments
Tidal Volume
Tracheostomy
Ventilation
Young Adult