Vocal cord paralysis is one of the most serious complications, which, in most situations, is preventable, associated with tracheal intubation. Unilateral vocal cord paralysis following tracheal intubation usually causes hoarseness. Postoperative vocal cord paralysis may be due to mechanical or neurogenic factors. The patient complained of hoarseness one day after operation and coughing on swallowing water ten days after operation. The vocal cords were examined with a fiberoptic nasopharyngolaryngoscopy and the right vocal cord was fixed in the paramedian position. We present a case of unilateral vocal cord paralysis following endotracheal intubation in a 71-year-old male patient with descending colon carcinoma and left renal cell carcinoma.
Aged ; Carcinoma, Renal Cell ; Colon, Descending ; Cough ; Deglutition ; Hoarseness ; Humans ; Intubation ; Intubation, Intratracheal ; Male ; Vocal Cord Paralysis ; Vocal Cords ; Water

Therapeutic bronchoscopy is widely employed as an effective first-line treatment for patients with central airway obstructions. Airway fires during rigid bronchoscopy are rare, but can have potentially devastating consequences. Pulmonologist and anesthesiologist undertaking this type of procedure should be aware of this serious problem and be familiar with measures to avoid this possibly fatal complication. We report the case of a 24-year-old patient with a silicone stent who experienced an electrocautery-induced airway fire during rigid bronchoscopy.
Airway Obstruction ; Bronchoscopy ; Electrocoagulation ; Fires ; Humans ; Mortuary Practice ; Silicones ; Stents ; Young Adult

Aortoiliac occlusive disease occurs commonly in patients with peripheral arterial disease. Aortofemoral bypass is the most common surgical procedure to treat aortoiliac occlusive disease. Intraoperative renal artery embolism is rare complication that may occur during aortofemoral bypass in patients with aortoiliac occlusive disease. It is very important to prevent the risk of subsequent renal artery thrombotic or atheromatous embolism during aortofemoral bypass in patients with juxtarenal aortic occlusion because of accidentally dislodging fragments or atheromatous emboli into the renal arteries. Emboli to one or more major renal arteries are an occasional cause of renal failure. We report a case of renal artery embolism in patient with aortoiliac occlusive disease and unilateral renal atrophy during aortobifemoral bypass graft.
Atrophy ; Embolism ; Humans ; Peripheral Arterial Disease ; Renal Artery ; Renal Insufficiency ; Transplants

Large symptomatic vallecular cyst is rare, but may cause difficulty or inability in conventional tracheal intubation during induction of general anesthesia. A flexible fiberoptic bronchoscope is the most useful general purpose aid to awake intubation in the patient with a known difficult airway. We experienced a case of flexible video image fiberoptic bronchoscopic awake orotracheal intubation in a patient with the large symptomatic vallecular cyst. A 35-year-old male suffered from foreign body sensation, voice change and dyspnea one month after upper respiratory tract infection. The two step flexible fiberoptic bronchoscopic approach was performed in the management of a known difficult intubation due to a vallecular cyst. We had an uneventful general anesthesia for removal of large symptomatic vallecular cyst because we anticipated difficult intubation.
Adult ; Anesthesia, General ; Bronchoscopes ; Dyspnea ; Foreign Bodies ; Humans ; Intubation ; Male ; Respiratory Tract Infections ; Sensation ; Voice

Large symptomatic vallecular cyst is rare, but may cause difficulty or inability in conventional tracheal intubation during induction of general anesthesia. A flexible fiberoptic bronchoscope is the most useful general purpose aid to awake intubation in the patient with a known difficult airway. We experienced a case of flexible video image fiberoptic bronchoscopic awake orotracheal intubation in a patient with the large symptomatic vallecular cyst. A 35-year-old male suffered from foreign body sensation, voice change and dyspnea one month after upper respiratory tract infection. The two step flexible fiberoptic bronchoscopic approach was performed in the management of a known difficult intubation due to a vallecular cyst. We had an uneventful general anesthesia for removal of large symptomatic vallecular cyst because we anticipated difficult intubation.
Adult ; Anesthesia, General ; Bronchoscopes ; Dyspnea ; Foreign Bodies ; Humans ; Intubation ; Male ; Respiratory Tract Infections ; Sensation ; Voice

Ketamine is a rapidly acting dissociative anesthetic that can be administered as a sole agent, an induction agent, or a supplement to low potency anesthetic agents.It is usually used for the minor surgery or outpatient surgery in pediatric anesthesia because of the undesirable psychotomimetic side effects of ketamine are less common in the children. We report that a pediatric patient had experienced a profound paralytic ileus after ventilation tube insertion with ketamine anesthesia.
Ambulatory Surgical Procedures ; Anesthesia ; Child ; Humans ; Ileus ; Intestinal Pseudo-Obstruction ; Ketamine ; Surgical Procedures, Minor ; Ventilation

Ketamine is a rapidly acting dissociative anesthetic that can be administered as a sole agent, an induction agent, or a supplement to low potency anesthetic agents.It is usually used for the minor surgery or outpatient surgery in pediatric anesthesia because of the undesirable psychotomimetic side effects of ketamine are less common in the children. We report that a pediatric patient had experienced a profound paralytic ileus after ventilation tube insertion with ketamine anesthesia.
Ambulatory Surgical Procedures ; Anesthesia ; Child ; Humans ; Ileus ; Intestinal Pseudo-Obstruction ; Ketamine ; Surgical Procedures, Minor ; Ventilation

Patients with diabetes or chronic renal failure may develop profound hypotension after anesthesia induction. In a patient with chronic renal failure, inappropriate dialysis may aggravate the hypotension. Combined autonomic neuropathy in diabetes mellitus is the main cause of the undesirable changes in blood pressure after anesthesia induction. We report a case of hypotension refractory to fluid replacement and inotropes in a patient with chronic renal failure for 10 years and diabetes mellitus for 5 years. The patient received hemodialysis on the day before surgery and had developed various symptoms suggestive of autonomic neuropathy (i.e., dizziness on standing, esophageal spasm, intermittent diarrhea).
Anesthesia ; Blood Pressure ; Diabetes Mellitus ; Diabetic Neuropathies ; Dialysis ; Dizziness ; Esophageal Spasm, Diffuse ; Humans ; Hypotension ; Kidney Failure, Chronic ; Renal Dialysis

Perioperative cerebral infarction is uncommon and its mechanism is often uncertain. This is a report of an unusual case of acute cerebral infarction following general anesthesia. The patient was a 83-year-old female admitted for total hip replacement arthroplasty (THRA). There were no previous cerebro- and cardio-vascular symptoms and history. During introduced general anesthesia with sevoflurane, there was a persistent low systolic BP of 80-100 mmHg (preoperative BP was 140/85 mmHg). On emerging from anesthesia, confusion and dense right hemiparesis were observed. Emergency CT brain scan showed early cerebral infarction in the middle cerebral artery (MCA) territory. Even though prompt supportive neurosurgical intensive care was initiated, the patient died at postoperative 4 days.
Aged, 80 and over ; Anesthesia ; Anesthesia, General ; Arthroplasty* ; Arthroplasty, Replacement, Hip* ; Brain ; Cerebral Infarction* ; Emergencies ; Female ; Humans ; Critical Care ; Middle Cerebral Artery ; Paresis

We report here on a case of a patient who developed paraplegia after thoracic epidural block that was done for the management of postherpetic neuralgia, and the patient was later diagnosed with spine metastasis from prostate cancer. This patient developed paraplegia of both lower extremities 2 weeks after the epidural block. We took X-ray and performed MRI of the thoracic spine for the differential diagnosis of paraplegia associated with herpes zoster, complications of epidural block or other diseases. The diagnosis of the paraplegia was spinal cord compression at T8, and this was caused by metastatic tumor that originated from prostate cancer. When we encounter paraplegia after epidural block, we should also consider other diseases as well as the complications of epidural block like direct neural damage, abscess and hematoma. Especially when there is the possibility of cancer, early detection, an accurate diagnosis and timely treatment can provide the best chance to ameliorate further medical consequences and optimize the quality of life.
Abscess ; Diagnosis ; Diagnosis, Differential ; Hematoma ; Herpes Zoster ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Neoplasm Metastasis* ; Neuralgia, Postherpetic ; Paraplegia ; Prostate ; Prostatic Neoplasms ; Quality of Life ; Spinal Cord Compression ; Spine