기관내삽관 후 발생한 후두육아종

Abstract

Post-intubation granuloma of the larynx is a rare complication. Post-intubation granuloma are associated with direct mechanical irritation of laryngeal mucosa from trauma, prolonged period of endotracheal intubation, multiple intubation, endotracheal movement. This study was performed retrospectively to evaluate symptom, location of lesion. treatment and prevention of the intubation granuloma. The patients aged from 26 to 64 years old. The male to female ratio was 3:12 in favor of female, predominantly female. The location of lesion was bilateral(4 cases) and unilateral(left side 2 cases, right side 9 cases). The clinical symptom was hoarseness and dyspnea. The peak duration between endotracheal intubation and symptom development was 4∼5 weeks. Duration of endotracheal intubation was 1 hour in 2 cases, 1∼3 hours in 9 cases, 3∼6 hours in 1 case, 6∼9 hours in 1 case, more than 3 days in 2 cases. 2 cases were recurred. To remove post-intubation granuloma of the larynx, all patients were administered triflupro-mazine(VeprinR). nalbuphine hydrochloride and glycopyrrolate intramuscular before anesthe-sia-induction 1 hour for premedication. Induction was established with pentothal sodium and succinylcholine after preoxygenation. N2O/O2(2: 1), enflurane and vecuronium chloride were administered for maintenance. ECG, pulse oximeter and ETCO2 were monitored. To remove the post-intubation granuloma of the larynx, laryngeal irritation and duration of intubation must be minimized.