Laryngospasm following orthognathic surgery: an unusual case report
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This study discusses laryngospasm following orthognathic surgery and requiring emergency intubation, followed by systemic complications due to a hypoxic event. A 34-year-old male patient underwent orthognathic surgery due to facial asymmetry. When emerging from general anesthesia, blood pressure elevated suddenly, and severe agitation occurred. After extubation, desaturation occurred immediately, resulting in cyanosis and loss of consciousness. An emergency cricothyroidotomy was performed, and oral intubation was required to maintain the airway. The patient was sent to the intensive care unit on a ventilator. On postoperative day 2, the red blood cell count and hemoglobin level decreased significantly. Electrocardiogram showed abnormalities, although vital signs were stable and no bleeding was observed. Laryngospasm often occurs under general anesthesia, resulting in sustained closure of the vocal cords and obstruction of the airway. This condition can be life-threatening, and awareness of the various precipitating factors is important. Orthognathic surgery is a risk factor for laryngospasm because its surgical site affects the airway, and it involves discharge of blood via intraoral wounds. It is important to understand systemic changes occurring after a hypoxic event, and consultation with specialists from various departments should be actively pursued.
Abstract
This study discusses laryngospasm following orthognathic surgery and requiring emergency intubation, followed by systemic complications due to a hypoxic event. A 34-year-old male patient underwent orthognathic surgery due to facial asymmetry. When emerging from general anesthesia, blood pressure elevated suddenly, and severe agitation occurred. After extubation, desaturation occurred immediately, resulting in cyanosis and loss of consciousness. An emergency cricothyroidotomy was performed, and oral intubation was required to maintain the airway. The patient was sent to the intensive care unit on a ventilator. On postoperative day 2, the red blood cell count and hemoglobin level decreased significantly. Electrocardiogram showed abnormalities, although vital signs were stable and no bleeding was observed. Laryngospasm often occurs under general anesthesia, resulting in sustained closure of the vocal cords and obstruction of the airway. This condition can be life-threatening, and awareness of the various precipitating factors is important. Orthognathic surgery is a risk factor for laryngospasm because its surgical site affects the airway, and it involves discharge of blood via intraoral wounds. It is important to understand systemic changes occurring after a hypoxic event, and consultation with specialists from various departments should be actively pursued.
참고문헌 (13)
- Gavel G, "Laryngospasm in anaesthesia", Contin Educ Anaesth Crit Care Pain, 14, pp.47~51 (2014)[DOI]
- Landsman IS, "Mechanisms and treatment of laryngospasm", Int Anesthesiol Clin, 35, pp.67~73 (1997)[DOI]
- Alalami AA, "Laryngospasm : review of different prevention and treatment modalities", Paediatr Anaesth, 18, pp.281~288 (2008)[DOI]
- Hampson-Evans D, "Pediatric laryngospasm", Paediatr Anaesth, 18, pp.303~307 (2008)[DOI]
- Janaszak-Jasiecka A, "Endothelial dysfunction driven by hypoxia-the influence of oxygen deficiency on NO bioavailability", Biomolecules, 11, pp.982~ (2021)[DOI]
- Del Re DP, "Mechanisms of ischemic heart injury", Cells, 11, pp.1384~ (2022)[DOI]
- Rutt AL, "Management of refractory laryngospasm", J Voice, 35, pp.633~635 (2021)[DOI]
- Sibert KS, "Extubation and the risks of coughing and laryngospasm in the era of coronavirus disease-19(COVID-19)", Cureus, 12, pp.e8196~ (2020)[DOI]
- Chang WC, "Negative-pressure pulmonary edema after laparoscopic appendectomy", JAAPA, 32, pp.28~30 (2019)[DOI]
- Al-alami AA, "Pediatric laryngospasm : prevention and treatment", Curr Opin Anaesthesiol, 22, pp.388~395 (2009)[DOI]
- Blackwell SC, "Timing of fetal nucleated red blood cell count elevation in response to acute hypoxia", Biol Neonate, 85, pp.217~220 (2004)[DOI]
- Devereaux PJ, "Myocardial injury after non-cardiac surgery : diagnosis and management", Eur Heart J, 41, pp.3083~3091 (2020)[DOI]
- Anupama BK, "A review of acute myocardial injury in coronavirus disease 2019", Cureus, 12, pp.e8426~ (2020)[DOI]