Endotracheal anesthesia for tubal connection surgery

This is an automatically translated article.

The article is expertly consulted by an Anesthesiologist, anesthesiologist, anesthesiologist - Department of General Surgery & Anesthesia - Vinmec Hai Phong International General Hospital.

1. What is endotracheal anesthesia?

Endotracheal anesthesia is a technique of general anesthesia with endotracheal intubation with the aim of controlling the patient's breathing during tubal anastomosis and postoperative resuscitation.

2. When is endotracheal anesthesia indicated in tubal anastomosis surgery?

Anesthesia method of endotracheal intubation will be indicated in the following cases:
Laparoscopic tubal surgery after sterilization; It is difficult to control the patient's airway with a mask; Orientation for maintenance of anesthesia with inhalational anesthetics. In addition, it is also important to note the relative contraindications of endotracheal anesthesia as follows:
No patient consent; Medical facilities do not have enough means of anesthesia and resuscitation; The technician is not well versed in this emotionless technique.

3. Possible complications in endotracheal anesthesia and corresponding management

Reflux of gastric juice into the airway: detect when there is digestive fluid in the oral cavity and airway, the patient should be treated:
Drain the fluid, let the patient lie down with the head low, tilt the head to the side; Rapid intubation of the endotracheal tube and aspiration of the airway fluid; Monitor and prevent complications of lung infection after surgery. Hemodynamic disorders: manifested by lowering or increasing blood pressure, cardiac arrhythmias need to be treated depending on symptoms and causes
3.1 Intubation complications Failure to intubate: manage as standard difficult intubation or consider switching to another method of anesthesia; Misplaced endotracheal intubation into the stomach: auscultation of the lungs without alveolar murmurs, no measurement of EtCO2. Need to reintubate the patient's endotracheal tube; Vocal - air - bronchospasm: difficult or impossible ventilation, auscultation with rales or muted lungs. It is necessary to provide adequate oxygen, add sleeping pills and muscle relaxants to the patient to ensure ventilation and give bronchodilators and corticosteroids. If breathing cannot be controlled, difficult intubation procedures should be applied; Trauma when placing the tube: bleeding, broken teeth, damage to the vocal cords, falling foreign objects into the airway, ... need to be handled depending on the damage. 3.2 Respiratory complications The endotracheal tube is folded, retracted or pushed deep into the lungs, the respiratory system is lowered or opened, the oxygen source is exhausted, ... treatment is to ensure immediate ventilation and 100% oxygen supply along with the respiratory system. with finding and solving the cause.

3.3 Complications after extubation Patients may experience sore throat, hoarseness, laryngotracheal-bronchospasm, upper respiratory tract inflammation, laryngotracheal stenosis, ... management according to the cause and specific symptoms.
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