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Anesthesia

Intubation injury

04/23/2007

Question:

I just had outpatient surgery and was told afterwards they had a difficult time intubating me. I feel as though there is a loose piece of tissue in my throat which gags me. Will this heal on its own or should I be examined by an ENT? My throat is very red and swollen.

Answer:

NetWellness is not an emergency service and does not offer diagnostic or therapeutic advice. You must see your doctor. The following are general comments only.

Difficult intubation can result in significant injury to soft tissues in the airway. A tear in the lining of the pharynx (throat) can in rare cases extend through the wall of the pharynx and into the mediastinum. The mediastinum is the space around the heart and great vessels. Because the pharynx has many resident bacteria, a severe, even life-threatening infection can result. I am not suggesting that you have this type of injury, a "worst-case" scenario, only that is is foolhardy under these circumstances to seek advice from a consumer health information site, even one as expertly staffed as NetWellness.

The only way to determine whether you have a potentially serious injury is to immediately call your doctor and have this attended to, possibly including an examination by an ENT specialist.

A superficial pharyngeal tear or bruising should heal on its own. Antibiotic cover could be considered - again medical advice is needed to make this determination. Be sure to get as complete a description of what happened during your intubation, from the anesthesiologist. You need this information in order to avoid a repetition of this experience the next time you have a general anesthetic. Your anesthesiologist should be asked to document in writing whether the difficult intubation was expected or unexpected, whether mask ventilation (breathing for you through a mask rather than a tube) was difficult or easy, and what equipment was used. He or she might also be asked to suggest the best method of doing your intubation next time around. Try to get contact information which you can use for any future surgery - ask the next anesthesiologist to talk to the person who has just taken care of you.

For more information:

Go to the Anesthesia health topic, where you can:

Response by:

Gareth S Kantor, MD Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University