• Ryuji Tose, Takeshi Kubota, Kazuyoshi Hirota, Tetsuhiro Sakai, Hironori Ishihara, and Akitomo Matsuki.
• Department of Anesthesiology, University of Hirosaki School of Medicine, Hirosaki 036-8562.
• Masui. 2003 Nov 1;52(11):1218-20.

AbstractWe report here a case of obstruction of an reinforced endotracheal tube during laryngomicrosurgery under total intravenous anesthesia. In this case, we used a 6.0 mm ID reinforced endotracheal tube that had been used previously for other patients and sterilized two times by ethylene oxide gas. During the operation, the peak airway pressure increased gradually and eventually reached to 35 cmH2O. After the exchange of the endotracheal tube, ventilation was improved immediately. The endotracheal tube was occluded by dissection of internal wall. Several cases of reinforced tube obstruction have already been reported and in most of these cases the obstruction was related to their repeated use and nitrous oxide anesthesia. However, the present case showed that dissection of reinforced endotracheal tube could also occur during general anesthesia without using nitrous oxide. We should bear in mind that repeated use of reinforced endotracheal tube could induce a critical airway obstruction.

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