EQUINE VETERINARY EDUCATION / AE / MAY 2015
243
Conclusion
This case demonstrates an innovative solution to an unexpected complication of leaving a nasotracheal tube in situ during anaesthetic recovery in horses and highlights another risk that needs to be considered and managed when determining how best to maintain airway patency during the recovery period. Further investigation is needed to determine the exact cause of nasotracheal tube breakage whilst the importance of meticulous maintenance and regular inspection of equipment should be emphasised.
Authors’ declaration of interests No conflicts of interest have been declared.
Acknowledgements
Thanks to J. Geoffrey Lane FRCVS for his assistance with tube removal.
Manufacturers’ addresses
1Novartis Animal Health UK Ltd, Hertfordshire, UK. 2Martindale Pharmaceuticals, Essex, UK. 3Boehringer Ingelheim Ltd, Berkshire, UK. 4Vetoquinol UK Ltd, Buckingham, UK. 5Hameln Pharmaceuticals Ltd, Gloucester, UK. 6Kruuse, Langeskov, Denmark. 7Abbott Laboratories Ltd, Kent, UK. 8Roche Products Ltd, Welwyn Garden City, Hertfordshire, UK. 9BSN Medical, Hull, UK. 10Vygon Ltd, Wiltshire, UK. 11Becton, Dickinson and Company Medical Supplies, Oxford, UK. 12Intervet International, Buckinghamshire, UK. 13SPH Supplies Ltd, Essex, UK.
References
Abrahamsen, E.J., Bohanon, T.C., Bednarski, R.M., Hubbell, J.A. and Muir, W.W. 3rd (1990) Bilateral arytenoid cartilage paralysis after inhalation anesthesia in a horse. J. Am. Vet. Med. Ass. 197, 1363-1365.
Ayala, J. and Coe, A. (1997) Thermal softening of tracheal tubes: an unrecognised hazard of the Bair Hugger active patient warming system. Br. J. Anaesth. 4, 543-545.
Bednarski, R. (2009) Tracheal and nasal intubation. In: Equine Anaesthesia, 2nd edn., Eds: W. Muir and J. Hubbell, Saunders Elsevier, St Louis. pp 277-287.
Bettschart-Wolfensberger, R. (2012) Recovery from anesthesia. In: Equine Surgery, 4th edn., Eds: J. Auer and J. Stick, Saunders Elsevier, St Louis. pp 246-253.
Coumbe, K. (1998) Anaesthetic complications and emergencies: part 2. Equine Vet. Educ. 15, 81-88.
Dixon, P. (1988) Tracheostomy in the horse. In Pract. 10, 249-253.
Dixon, P.M., Railton, D.I. and McGorum, B.C. (1993) Temporary bilateral laryngeal paralysis in a horse associated with general anaesthesia and post anaesthetic myositis. Vet. Rec. 132, 29-32.
Heath, R.B., Steffey, E.P., Thurmon, J.C., Wertz, E.M., Meagher, D.M., Hyyppa, T. and Van Slyke, G.L. (1989) Laryngotracheal lesions following routine orotracheal intubation in the horse. Equine Vet. J. 21, 434-437.
Holland, M., Snyder, J.R., Steffey, E.P. and Heath, R.B. (1986) Laryngotracheal injury associated with nasotracheal intubation in the horse. J. Am. Vet. Med. Ass. 189, 1447-1450.
Kollias-Baker, C.A., Pipers, F.S., Heard, D. and Seeherman, H. (1993) Pulmonary edema associated with transient airway obstruction in three horses. J. Am. Vet. Med. Ass. 202, 116-118.
Lane, J.G. (2003) 5-point grading system of laryngeal function in horses during quiet breathing. In: Proceedings of a Workshop on Equine Recurrent Laryngeal Neuropathy. Eds: P. Dixon, E. Robinson and J.F. Wade. R and W Publications, Newmarket. pp 24-25.
Lukasik, V.M., Gleed, R.D., Scarlett, J.M., Ludders, J.W., Moon, P.F., Ballenstedt, J.L. and Sturmer, A.T. (1997) Intranasal phenylephrine reduces post anaesthetic upper airway obstruction in horses. Equine Vet. J. 29, 236-238.
Pauwels, F. (2006) Temporary tracheostomy. In: Manual of Equine Anaesthesia and Analgesia, Eds: T. Doherty and A. Valverde, Blackwells Publishing Ltd, Oxford, UK. pp 62-66.
Saulez, M.N., Dzikiti, B. and Voigt, A. (2009) Traumatic perforation of the trachea in two horses caused by orotracheal intubation. Vet. Rec. 164, 719-722.
Solomons, N.B. (1987) Hazard of the tracheal t-tube; a method of removal. Int. J. Paediatr. Otorhinolaryngol. 14, 171-173.
Southwood, L., Baxter, G.M. and Wagner, A.E. (2003) Severe postanaesthetic upper respiratory tract obstruction in horses: 8 cases (1993–2001) [Abstract]. Vet. Surg. 32, 602.
Southwood, L. and Gaynor, J. (2003) Postanaesthetic upper respiratory tract obstruction. In: Current Therapies in Equine Medicine, 5th edn., Ed: N.E. Robinson, Saunders Elsevier, St Louis. pp 391-393.
Takanami, I., Abiko, T. and Kurihara, H. (2007) Fracture of silicone tracheal T-tube: a rare complication. J. Thorac. Cardiovasc. Surg. 134, 1362-1363.
Taylor, P.M. and Clarke, K.W. (2007) Anaesthetic problems. In: Handbook of Equine Anaesthesia, 2nd edn., Saunders Elsevier, Philadelphia. pp 123-175.
Thomas, S.J., Corbett, W.T. and Meyer, R.E. (1987) Risk factors and comparative prevalence rates of equine postanaesthetic respiratory obstruction at NCSU [Abstract]. Vet. Surg. 16, 324.
Thong, Y. and Wong, S. (2011) Kinking of the endotracheal tube: an unusual complication of inserting a pre-warmed nasotracheal tube. Asian J. Anaesth. 12, 86-90.
Touzot-Jourde, G., Stedman, N.L. and Trim, C.M. (2005) The effects of two endotracheal tube cuff inflation pressures on liquid aspiration and tracheal wall damage in horses. Vet. Anaesth. Analg. 32, 23-29.
Wagner, A. (2008) Complications in equine anaesthesia. Vet. Clin. N. Am.: Equine Pract. 24, 735-752.
Wong, S.Y., Tseng, C.H., Wong, K.M., Chen, K.T. and Chen, C. (2002) Aspiration of a dislodged endotracheal tube: a rare cause of acute total airway obstruction. Chang Gung Med. J. 7, 515-519.
© 2015 EVJ Ltd
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84
