Korean J Anesthesiol.  2011 May;60(5):373-376. 10.4097/kjae.2011.60.5.373.

Bilateral tension pneumothorax caused by an abrupt increase in airway pressure during cervical spine surgery in the prone position: A case report

• Lee JY
• Kim JU
• An EH
• Song E
• Lee YM

• KMID: 1780185
• DOI: http://doi.org/10.4097/kjae.2011.60.5.373

Abstract

Elevated peak inspiratory airway pressure (PIP) can occur during general anesthesia and is usually easily rectified. In rare circumstances it can lead to potentially fatal conditions such as tension pneumothorax. We report on a 77-year-old male patient admitted for a cervical laminoplasty. The preoperative chest radiograph showed normal findings and there was no medical history of allergy or underlying airway inflammation. Anesthesia induction and maintenance progressed uneventfully. However, 5 minutes after prophylactic antibiotic administration, PIP suddenly increased and blood pressure dropped. The operation was abandoned and the patient was moved to a supine position to perform chest radiography. Cardiac arrest occurred, and cardiopulmonary resuscitation was performed. The radiograph showed bilateral tension pneumothorax. Needle aspiration was immediately performed, and chest tubes were inserted. Ventilation rapidly improved and the vital signs normalized. The patient was discharged without sequelae on postoperative day 36.

Keyword

Anaphylaxis; Cardiac arrest; Peak inspiratory airway pressure; Tension pneumothorax

MeSH Terms

Aged
Anaphylaxis
Anesthesia
Anesthesia, General
Blood Pressure
Cardiopulmonary Resuscitation
Chest Tubes
Heart Arrest
Humans
Hypersensitivity
Inflammation
Male
Needles
Pneumothorax
Spine
Supine Position
Thorax
Ventilation
Vital Signs