A case report of upper airway obstruction following long-term use of LMA in surgery

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Eftekharian Fatemeh; Kalani Navid; Sahraei Reza

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Journal Paper

Paper Information

Journal: Pars Journal of Medical Sciences Year:2023 | Volume:21 | Issue:2 Page(s): 78-82

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Information Journal Paper

Title

A case report of upper airway obstruction following long-term use of LMA in surgery

Author(s)

Eftekharian Fatemeh | Kalani Navid | Sahraei Reza | Issue Writer Certificate

Keywords

Upper airway obstructionQ4

Laryngeal Mask AirwayQ4

LaryngospasmQ4

surgeryQ4

Abstract

Introduction: Laryngeal spasm is the narrowing or complete closure of the glottis due to the reflex contraction of thelaryngeal muscles. The present study reports a case of Upper airway obstruction following long-term use of a Laryngeal Mask Airway in surgery.Case Presentation: A 45-year-old female patient who referred to a urologist due to urological problems with complaints of urinary bleeding and pain in the urogenital area. Based on trusting the surgeon's words about the shortness of the surgery, a Laryngeal Mask Airway was used for the patient, and propofol was used to anesthetize the patient during the operation. The patient's surgery gradually took longer due to suspicion of malignancy in the urinary tract and bladder, and the surgeon extended the surgery almost every 15 minutes. Finally, the surgery was completed after nearly three hours, and despite the fact that the patient had not taken any special medicine except propofol an hour before the end of the operation, but when he woke up, he had difficulty breathing. Although the patient was completely relaxed with neostigmine and atropine, he had airway obstruction, especially in the upper part of the airway, just like asthma patients. Because the patient's breathing was severely disturbed, salbutamol spray, hydrocortisone ampoule (100 mg + 100 mg), aminophylline and finally epinephrine 5 micrograms were used for three doses, but the patient's breathing was still difficult and the patient had to be intubated after We received propofol and atracurium. After about 30 minutes passed and the conditions were suitable, we extubated the patient with special precautions and transferred him to the intensive care unit for recovery and for further assurance.Conclusion: Based on the results of the present study, long-term use of Laryngeal Mask Airway is associated with the occurrence of Laryngospasm after surgery, which can be considered as a result of long-term stimulation of the upper airway by the Laryngeal Mask Airway.

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