The difficult removal of tracheal tube after general anesthesia: A case report

Abstract

Background: Laryngeal injury is common after endotracheal intubation, presenting with varying degrees of edema, ulceration, granulation, and limited vocal cord movement, usually resulting in lumen narrowing. In these cases, laryngeal edema is a common complication after intubation, usually caused by direct pressure and inflammatory reaction caused by endotracheal intubation on the contact surface.

Case presentation: A 71-year-old female was scheduled to undergo open reduction and internal fixation of femoral neck. On admission, she was diagnosed with femoral neck fracture. Tracheal intubation induced by general anesthesia was successful, but the tracheal catheter was difficult to remove after the operation. After 2 days of detumescence in ICU, the extubation was successful under the condition of complete recovery of spontaneous breathing.

Conclusions: Patients undergoing general anesthesia may have laryngeal or glottic edema due to operation time, operation and other reasons, resulting in difficulty in extubation after general anesthesia. The extubation action shall be gentle. In case of obvious resistance, it shall not be forcibly extubated to prevent serious dyspnea after extubation.

Figure 1.

Video laryngoscopy with tube: during the tracheal tube with tube, the glottis mucosa was swollen obviously by laryngoscope.

Figure 2.

CT with tube: CT scan of the neck during tracheal tube placement showed obvious edema of the soft tissue around the glottis. CT = computerized tomography.

Figure 3.

CT after extubation: CT scan of the neck after tracheal catheter extraction showed that soft tissue swelling around the glottis was reduced. CT = computerized tomography.