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Abstract

Inadvertent placement of the endotracheal tube into the right bronchus during intubation for general anesthesia is a fairly common occurrence. Many precautions should be taken by the anesthesia provider in order to minimize the incidence of endobronchial intubation, including bilateral auscultation of the lungs, use of the 21/23 rule, and palpation of the inflated endotracheal cuff at the sternal notch. These provisions, however, are not foolproof; anesthesia providers should realize that endobronchial intubation may occur from time to time because of variations in patient anatomy, changes in patient positioning, and cephalad pressures exerted during surgery. A 58-year-old man with chronic obstructive pulmonary disease received general endotracheal anesthesia for a laparoscopic cholecystectomy. His height was 165 cm (5 ft, 5 in) and the endotracheal tube was secured at his incisors at 21 cm after placement with a rigid laryngoscope. Bilateral breath sounds were confirmed with auscultation, although they were distant because of his chronic obstructive pulmonary disease. After radiographic examination in the postanesthesia care unit, a right main-stem intubation was revealed to have taken place, resulting in complete atelectasis of the left lung. After repositioning of the endotracheal tube, radiography confirmed that the patient had an anatomically short tracheal length.

Keywords: Endobronchial intubation; Main-stem intubation; Short neck length; General anesthesia
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Copyright: © 2015 by the American Dental Society of Anesthesiology
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Article Contents

Comparison of Remimazolam and Propofol for Intubated General Anesthesia for Oral and Maxillofacial Surgery

Yoshio Hayakawa DDS, PhD,
 Keiko Fujii-Abe DDS, PhD,
 Sayaka Akitomi DDS,
 Shihomi Niwa DDS,
 Michiru Abe DDS,
 Manami Otsuka DDS, PhD,
 Maho Ikeda DDS,
 Takumi Ishikawa DDS, PhD,
 Manami Yajima DDS, PhD, and
 Hiroshi Kawahara DDS, PhD

The Impact of COVID-19 on Dental Anesthesiologists: An Online Survey of Board-Certified Dental Anesthesiology Specialists of the Japanese Dental Society of Anesthesiology

Takuro Sanuki DDS, PhD,
 Hidetaka Kuroda DDS, PhD,
 Uno Imaizumi DDS, PhD,
 Shota Tsukimoto DDS, PhD,
 Norika Katagiri DDS, PhD,
 Ayako Mizutani DDS, PhD,
 Mari Ohnaka DDS,
 Shinji Kurata DDS, PhD,
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 Kanta Kido DDS, PhD

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