No abstract

Tracheoesophageal fistula may be either a congenital lesion or an acquired condition, most often resulting from foreign body ingestion. Location of the lesion has implications for anesthetic management and single lung ventilation may be required to facilitate surgical repair. In pediatric patients, intentional mainstem intubation may be required.

S u m m a r y Difficulties in removing the tracheal tube from the trachea are relatively uncommon. We report here a case of difficult extubation which was precipitated by pulling of the pilot balloon and valve assembly in order to dejate the cufl.

Smaller-than-expected concentrations of sevoflurane were delivered by Sevotec 5 vaporizers (Datex-Ohmeda, Madison, WI) at low-fill states, 8% dialed concentrations, and high fresh gas flows. Clinically, this would lead to prolonged induction times. The risk of complications from prolonged inhaled induction could be increased when using a vaporizer with these characteristics.