Bilateral tension pneumothorax caused by an abrupt increase in airway pressure during cervical spine surgery in the prone position: A case report.
10.4097/kjae.2011.60.5.373
- Author:
Jae Young LEE
1
;
Joung Uk KIM
;
Eun Hye AN
;
Eun SONG
;
Yu Mi LEE
Author Information
1. Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ylee@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Anaphylaxis;
Cardiac arrest;
Peak inspiratory airway pressure;
Tension pneumothorax
- MeSH:
Aged;
Anaphylaxis;
Anesthesia;
Anesthesia, General;
Blood Pressure;
Cardiopulmonary Resuscitation;
Chest Tubes;
Heart Arrest;
Humans;
Hypersensitivity;
Inflammation;
Male;
Needles;
Pneumothorax;
Spine;
Supine Position;
Thorax;
Ventilation;
Vital Signs
- From:Korean Journal of Anesthesiology
2011;60(5):373-376
- CountryRepublic of Korea
- Language:English
-
Abstract:
Elevated peak inspiratory airway pressure (PIP) can occur during general anesthesia and is usually easily rectified. In rare circumstances it can lead to potentially fatal conditions such as tension pneumothorax. We report on a 77-year-old male patient admitted for a cervical laminoplasty. The preoperative chest radiograph showed normal findings and there was no medical history of allergy or underlying airway inflammation. Anesthesia induction and maintenance progressed uneventfully. However, 5 minutes after prophylactic antibiotic administration, PIP suddenly increased and blood pressure dropped. The operation was abandoned and the patient was moved to a supine position to perform chest radiography. Cardiac arrest occurred, and cardiopulmonary resuscitation was performed. The radiograph showed bilateral tension pneumothorax. Needle aspiration was immediately performed, and chest tubes were inserted. Ventilation rapidly improved and the vital signs normalized. The patient was discharged without sequelae on postoperative day 36.
