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September 12, 1959, Vol 171, No. 2 >
ARTICLE | September 12, 1959

PNEUMOTHORAX AND EXTENSIVE EMPHYSEMA AFTER HIGH INTRATRACHEAL PRESSURE IN ANESTHETIZATION

Joachim S. Gravenstein, M.D.
JAMA. 1959;171(2):158-160. doi:10.1001/jama.1959.03010200026007.
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During certain manipulations of a machine for inhalation anesthesia, a mixture of oxygen and nitrous oxide entered the patient's trachea suddenly and under sufficient pressure to escape into surrounding structures of the neck and chest. Pneumothorax on the left and mediastinal, muscular, subcutaneous, and retroperitoneal emphysema developed at once and were demonstrated in roentgenograms. The respiratory distress was relieved by mouth-to-endotracheal-tube ventilation, and the patient's pulse again became palpable; the ectopic gases were absorbed within a few hours, and the patient recovered without further complications. The arrangement of valves that made this accident possible has since been corrected by the manufacturer. Anesthesiologists must be alert to the possibility of such accidents with any form of anesthesia machines.

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