RESUMO
A 58-year-old female patient was prescribed different drugs in both tablet and powder form and inadvertently ingested the tablet along with its press through package (PTP), which thus became lodged in the subglottic region. An emergency operation was then performed to remove this foreign material, under neuroleptic anesthesia, and the foreign material was removed successfully. Furthermore, no abnormal findings, such as enlarged vocal cords, were noted. Vocal cord granuloma developed three months after the operation but it improved after conservative treatment.
Assuntos
Anestesia , Embalagem de Medicamentos , Corpos Estranhos/cirurgia , Glote/cirurgia , Comprimidos/efeitos adversos , Droperidol , Emergências , Feminino , Fentanila , Granuloma de Corpo Estranho/etiologia , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento , Prega VocalRESUMO
This report describes anesthetic management of a case (a 64-year-old man) who was originally diagnosed as paraesophageal hernia before surgery and later diagnosed as Bochdalek hernia during laparoscopic surgery. Anesthesia was started with oxygen, nitrous oxide, and sevoflurane, and respiration was managed using controlled mechanical ventilation. Although left pneumothorax was noticed during laparoscopic surgery (aeroperitonia pressure: 10 cmH2O), the surgery was performed using the same anesthesia procedure, because hardly any changes were observed on the monitor and vital signs were stable. The surgery was completed without incident. However, postoperative chest X-rays revealed the residual large pneumothorax. A chest drain tube was inserted immediately, after which the pneumothorax was improved. Pneumothorax is considered to be inevitable in cases of laparoscopic repair of Bochdalek hernia. To prevent exacerbation of pneumothorax, anesthetic management should consist of discontinuing the use of nitrous oxide and lowering the aeroperitonia pressure concomitently with the use of positive airway pressure.