Efficacy of esophago＇-pharyngeal tube for airway management in patients undergoing operation on language areas

Abstract

Three ASA II male patients aged 22-46 yr weighing 50-75 kg underwent operation on language areas from June to September 2009 in our hospital. Anesthesia was induced with propofol 2-2.5 mg/kg, fentanyl 4- 5 ug/kg and atraeurium 0.6 mg/kg. The esophago-pharyngea1 tube was inserted into esophagus and oropharynx under direct vision. The esophageal balloon was inflated with 10-15 ml of air and the pharyngeal balloon with 40- 60 ml of air. After the correct position of the tube was confirmed, the patients were mechanically ventilated. Anesthesia was maintained with propofol 50-70 ug·kg- 1 ·min- 1 , remifentanil 0.15-0.25 ug · kg- 1 · min-1 and atracurium 0.3-0.4 ug· kg-1· h-1 . The pharyngeal balloon was deflated during wake-up test. The patients were asked to count continuously and answer question as instructed to locate the language areas. After the language areas bad been located, the pharyngeal balloon was inflated again. The tidal volume was set at 500-510 ml and measured 500-512 ml. The airway pressure measured 16-18 cm H2O. The hemodynamies was stable and blood gas indexes were within the normal range. The language in response to questions was clear in one patient, not very clear in the second patient and vague in the third patient. Hypoxemia hypercapnea and intracranial hypertension were not observed during operation and wake-up test. After the patients became conscious, the balloons were deflated and the vital signs were stable. The patients were transferred to ICU after removal of esophago-pharyngeal tube. No postoperative complications occurred. Key words: Neurosurgical procedures; Wakefulness; Esophageal pharynx catheter