| Clinical Study of Pharyngeal Throat Pack - Cases of V-pack Application to the Endotracheal Tubes . |
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Chang Suk Kim, Byung Ho Lee, Jae Yong Shim, Woon Hyok Chung |
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Department of Anesthesiology, Catholic Medical College, Seoul, Korea. |
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| Abstract |
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In performing general anesthesia, the endotracheal tubes are most commonly used and the space between trachea and tubes are sealed with inflatable cuffs to apply positive pressure ventilation. But in children, especially small children, a plain oral-tracheal tube is to be used. The subglottic region is very narrow and the tubes of the small diameter are used. The endotracheal tub. cuffs are not used and the largest correct sized tubes may cause air leak around them.
The V-pack, designed by Vickery and Burton and manufactured at Dentmad Ltd, England was used to seal the laryngeal inlet to control air leak during intermittent positive ventilation. This attempt seems to be very successful to prevent air leaks around trachea in case of ruptured inflatable cuffs of the adult during surgery. The damage of tracheal wall by increasing pressure of endotracheal cuff with nitrous oxide-oxygen anesthesia will be prevented when using V-packs. The V-packs were inserted with plain endotracheal tubes to throat to evaluate the efficacy of sealing the air leak around trachea and the post-operative sore throat with 10 adults(age between 21 and 72) and 10 children (age between 2 and 6). In the all cases, 1) The sealing of air leakage around throat with V-pack use was satisfactory. 2) Three out of ten adult cases, slight sore throat were complained but there were none such cases in children. 3) The V-pack was shown to te especially effective and convenient to seal the air leak around trachea when plain-endotracheal tubes were intubated through nasotracheal route. 4) Additionally, in two adult cases with the punctured endotracheal cuffs during surgery, the V-pack was satisfactory to seal the air leak around trachea during positive pressure ventilation. |
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