RESUMEN
The obstruction of an endotracheal tube with the patient in the prone position creates major anaesthetic difficulties that may result in patient morbidity and mortality. We describe a case involving the clearing of a blocked endotracheal tube with an arterial embolectomy catheter and discuss the relevance to anaesthetic practice.
Asunto(s)
Embolectomía/instrumentación , Complicaciones Intraoperatorias/terapia , Intubación Intratraqueal , Anciano , Femenino , Humanos , Intubación Intratraqueal/instrumentación , Posición PronaRESUMEN
OBJECTIVE: We report the first case of intravenous self-poisoning with Thiodan (30% endosulfan in xylene). CASE REPORT: A 28-year-old woman with a past history of epilepsy presented with refractory grand mal seizures after injecting 1 mL of Thiodan intravenously. She developed liver dysfunction, proximal myopathy secondary to rhabdomyolysis and renal failure. INTERVENTIONS AND OUTCOMES: The seizures were terminated with midazolam and thiopentone. Mechanical ventilation was required for nine days. Renal and liver dysfunction resolved with supportive measures only. Hemodialysis was not required. Pulmonary complications and neurological sequelae were minimal with the patient making a full recovery over three months. CONCLUSION: The intravenous adminis-tration of a small dose of endosulfan in xylene caused the rapid onset of severe grand mal seizures. The absence of pulmonary edema in this case suggests aspiration to be the cause of pulmonary toxicity due to oral endosulfan poisoning.