{"title":"使用新型声门上气道装置后单侧舌下神经麻痹","authors":"Bun Hui Ang, R. W. Leong, S. Fathil, K. H. Quek","doi":"10.4236/ojanes.2020.106020","DOIUrl":null,"url":null,"abstract":"Background: The LMA® Protector™ Airway is a new supraglottic airway device with Cuff Pilot™ Technology that enables visual monitoring of intra-cuff pressure, to reduce the risk of complications from an overinflated device. Case: We present a case of unilateral hypoglossal nerve injury after its use. In our knowledge, this is the first reported case of hypoglossal nerve injury after LMA® Protector™ use. Learning Points: Hypoglossal nerve injury is a rare but distressing complication of LMA use. The greater horn of the hyoid bone is a potential site of injury, as the cuff of the LMA may compress the nerve against bone. In our patient, possible contributing factors included cuff overinflation with/without failure of the Cuff Pilot™ technology, inappropriate sizing and placement of an unfamiliar device. Fortuitously, injury is often neuropraxia with complete recovery in 6 months following conservative management. Consideration should be given to down-sizing the device for Asian patients who tend to have smaller jaws for their weight range. We caution that whilst the green zone of the Cuff Pilot™ corresponds to 40 - 60 cm H2O cuff pressure, it may be more than the “just-seal” pressure required and the cuff may still be overinflated relative to the size of the patient’s airway.","PeriodicalId":56551,"journal":{"name":"麻醉学期刊(英文)","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2020-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Unilateral Hypoglossal Nerve Palsy after the Use of a Novel Supraglottic Airway Device\",\"authors\":\"Bun Hui Ang, R. W. Leong, S. Fathil, K. H. Quek\",\"doi\":\"10.4236/ojanes.2020.106020\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: The LMA® Protector™ Airway is a new supraglottic airway device with Cuff Pilot™ Technology that enables visual monitoring of intra-cuff pressure, to reduce the risk of complications from an overinflated device. Case: We present a case of unilateral hypoglossal nerve injury after its use. In our knowledge, this is the first reported case of hypoglossal nerve injury after LMA® Protector™ use. Learning Points: Hypoglossal nerve injury is a rare but distressing complication of LMA use. The greater horn of the hyoid bone is a potential site of injury, as the cuff of the LMA may compress the nerve against bone. In our patient, possible contributing factors included cuff overinflation with/without failure of the Cuff Pilot™ technology, inappropriate sizing and placement of an unfamiliar device. Fortuitously, injury is often neuropraxia with complete recovery in 6 months following conservative management. Consideration should be given to down-sizing the device for Asian patients who tend to have smaller jaws for their weight range. We caution that whilst the green zone of the Cuff Pilot™ corresponds to 40 - 60 cm H2O cuff pressure, it may be more than the “just-seal” pressure required and the cuff may still be overinflated relative to the size of the patient’s airway.\",\"PeriodicalId\":56551,\"journal\":{\"name\":\"麻醉学期刊(英文)\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-06-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"麻醉学期刊(英文)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4236/ojanes.2020.106020\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"麻醉学期刊(英文)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4236/ojanes.2020.106020","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
摘要
背景:LMA®Protector™气道是一种采用Cuff Pilot™技术的新型声门上气道设备,可以可视化监测袖带内压力,以降低过度充气设备引起并发症的风险。病例:我们报告一例单侧舌下神经使用后损伤的病例。据我们所知,这是使用LMA®Protector™后首次报道的舌下神经损伤病例。学习要点:舌下神经损伤是LMA使用后罕见但令人痛苦的并发症。舌骨的大角是一个潜在的损伤部位,因为LMA的袖带可能压迫神经与骨。在我们的患者中,可能的影响因素包括袖带过度膨胀,有/没有失败的cuff Pilot™技术,不合适的尺寸和放置不熟悉的设备。幸运的是,损伤通常是神经失用症,保守治疗后6个月完全恢复。亚洲患者的下颚相对于他们的体重范围来说更小,应该考虑缩小器械的尺寸。我们需要提醒的是,虽然Cuff Pilot™的绿色区域对应于40 - 60 cm H2O袖带压力,但它可能超过“刚刚密封”所需的压力,并且相对于患者气道的大小,袖带可能仍然过度膨胀。
Unilateral Hypoglossal Nerve Palsy after the Use of a Novel Supraglottic Airway Device
Background: The LMA® Protector™ Airway is a new supraglottic airway device with Cuff Pilot™ Technology that enables visual monitoring of intra-cuff pressure, to reduce the risk of complications from an overinflated device. Case: We present a case of unilateral hypoglossal nerve injury after its use. In our knowledge, this is the first reported case of hypoglossal nerve injury after LMA® Protector™ use. Learning Points: Hypoglossal nerve injury is a rare but distressing complication of LMA use. The greater horn of the hyoid bone is a potential site of injury, as the cuff of the LMA may compress the nerve against bone. In our patient, possible contributing factors included cuff overinflation with/without failure of the Cuff Pilot™ technology, inappropriate sizing and placement of an unfamiliar device. Fortuitously, injury is often neuropraxia with complete recovery in 6 months following conservative management. Consideration should be given to down-sizing the device for Asian patients who tend to have smaller jaws for their weight range. We caution that whilst the green zone of the Cuff Pilot™ corresponds to 40 - 60 cm H2O cuff pressure, it may be more than the “just-seal” pressure required and the cuff may still be overinflated relative to the size of the patient’s airway.