Korean J Anesthesiol.  2017 Feb;70(1):95-99. 10.4097/kjae.2017.70.1.95.

Postoperative negative pressure pulmonary edema following repetitive laryngospasm even after reversal of neuromuscular blockade by sugammadex: a case report

• Lee JH
• Lee JH
• Lee MH
• Cho HO
• Park SE

• KMID: 2402903
• DOI: http://doi.org/10.4097/kjae.2017.70.1.95

Abstract

Laryngospasm, an occlusion of the glottis, can occur at any time during anesthesia, and is associated with serious perioperative complications such as hypoxia, hypercabia, aspiration, bronchospasm, arrhythmia, prolonged recovery, cardiac collapse, and eventually catastrophic death. Importantly, postoperative negative pressure pulmonary edema (NPPE) is a rare, but well described life-threatening complication related to acute and chronic upper airway obstruction. Sugammadex well known for affirmatively reducing the postoperative pulmonary complications associated with residual neuromuscular blockade may have an indirect role in triggering the negative intrathoracic pressure by raising a rapid and efficacious respiratory muscle strength in acute upper airway obstruction. Herein, we report a case of postoperative NPPE following repetitive laryngospasm even after reversal of rocuronium-induced neuromuscular blockade using sugammadex.

Keyword

Laryngismus; Negative pressure pulmonary edema; Rocuronium; Sugammadex

MeSH Terms

Airway Obstruction
Anesthesia
Anoxia
Arrhythmias, Cardiac
Bronchial Spasm
Delayed Emergence from Anesthesia
Glottis
Laryngismus*
Neuromuscular Blockade*
Pulmonary Edema*
Respiratory Muscles