What is an intubation anesthesia?
Intubation anesthesia is a general anesthesia in which the sleeping patient is ventilated through a ventilation tube (tube) that is inserted into the trachea. Intubation is the gold standard of airway protection with the highest aspiration protection, i.e. a balloon inflated around the tube tightly seals the trachea to prevent backflow of stomach contents into the lungs.
Indication
The most important indication for intubation anesthesia is the increased risk of aspiration. Aspiration is the reflux of stomach contents via the esophagus into the trachea. When a patient is anaesthetized, the medication administered eliminates all protective reflexes, i.e. stomach contents that enter the trachea cannot be coughed up but flow silently into the lungs.
This can lead to considerable damage and inflammation in the lungs. Aspiration risk is present in all non fasting patients, i.e. anyone who ate something 6 hours before the operation or drank something 2 hours before the operation. The same applies to all emergency patients, people with craniocerebral trauma and/or unconscious persons, as there are also no protective reflexes.
In addition, all patients with increased intra-abdominal pressure (pressure in the abdomen) must be intubated. This is the case with particularly thick (obese) and pregnant women. The pressure causes the stomach to move upwards and increases the risk of backflow of stomach contents.
The pressure in the abdominal cavity is also increased during all abdominal operations, both laparoscopic and open surgery are affected. In laparoscopic surgery, the camera and surgical tool are inserted into the abdomen through small skin incisions. For a better view, the abdomen is filled with carbon dioxide and inflated, thus significantly increasing the pressure on the stomach.
Other operations that require intubation are operations in the nose, throat and mouth area, e.g. tonsillectomy or large craniofacial injuries, as blood can flow from there into the lungs. The blocked tube (inflated balloon around the tube) prevents this. Long operations lasting >3-4 hours should also be performed under intubation anesthesia. The same applies to operations in which the patient is placed in a prone position or is operated in a sitting position. Further indications are extensive burns, inhalation trauma, resuscitation, anaphylactic reactions and unbreakable status epilepticus.
