13. Light anaesthesia

13. Light anaesthesia

If anaesthesia is inadequate, the Patient’s chest compliance may fall, as there is an increase in muscular tone. The emergence of the Patient may stimulate breath holding, coughing or straining. Furthermore, light anaesthesia may induce laryngospasm or bronchospasm, both of which may cause the ventilation pressures to rise above the normal levels recommended (+/-20cmH2O). This decreased compliance may generate an audible leak on manual ventilation at peak pressure, which may be managed by increasing the Tulip’s cuff volume and pressure until the audible leak is obliterated, and the desired manual ventilation pressure achieved without the presence of an audible leak. Higher ventilation pressures (>20cmH2O) should be used with caution as they lead to an increased risk of gastric insufflation, dilation, regurgitation, reflux and their sequelae. The Tulip offers no protection what so ever against aspiration and its predisposing risks. Caution is indicated.