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Management of pulmonary aspiration due to undiagnosed achalasia during induction of general anesthesia - A case report -

BACKGROUND: Intraoperative pulmonary aspiration is a rare but potentially fatal complication associated with various risk factors. Preoperative recognition of these risk factors can prevent aspiration events during general anesthesia or facilitate prompt corrective measures in patients experiencing...

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Autores principales: Kim, Hee Jung, Choi, Yong Seon, Jin, Jeong Hyun, Lee, Bora
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Anesthesiologists 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9091672/
https://www.ncbi.nlm.nih.gov/pubmed/35280041
http://dx.doi.org/10.17085/apm.21102
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author Kim, Hee Jung
Choi, Yong Seon
Jin, Jeong Hyun
Lee, Bora
author_facet Kim, Hee Jung
Choi, Yong Seon
Jin, Jeong Hyun
Lee, Bora
author_sort Kim, Hee Jung
collection PubMed
description BACKGROUND: Intraoperative pulmonary aspiration is a rare but potentially fatal complication associated with various risk factors. Preoperative recognition of these risk factors can prevent aspiration events during general anesthesia or facilitate prompt corrective measures in patients experiencing this complication. CASE: A 70-year-old female patient with hypertension underwent bilateral total knee arthroplasty under general anesthesia. Despite using a midnight nothing-per-oral (NPO) protocol, an unpredictable intraoperative aspiration event occurred during anesthesia induction. A detailed evaluation of the patient’s medical history and subsequent diagnostic imaging examinations indicated achalasia. She was treated for aspiration pneumonia for 2 weeks. After 2 months, rescheduled total knee arthroplasty was performed under spinal anesthesia without any complications. CONCLUSIONS: Obtaining the patient’s medical history and assessing the risk factors are important to prevent unpredictable intraoperative pulmonary aspiration. High-risk patients should undergo adequate preoperative fasting and regional anesthesia or rapid-sequence intubation should be considered for safe induction of general anesthesia.
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spelling pubmed-90916722022-05-19 Management of pulmonary aspiration due to undiagnosed achalasia during induction of general anesthesia - A case report - Kim, Hee Jung Choi, Yong Seon Jin, Jeong Hyun Lee, Bora Anesth Pain Med (Seoul) Airway Management BACKGROUND: Intraoperative pulmonary aspiration is a rare but potentially fatal complication associated with various risk factors. Preoperative recognition of these risk factors can prevent aspiration events during general anesthesia or facilitate prompt corrective measures in patients experiencing this complication. CASE: A 70-year-old female patient with hypertension underwent bilateral total knee arthroplasty under general anesthesia. Despite using a midnight nothing-per-oral (NPO) protocol, an unpredictable intraoperative aspiration event occurred during anesthesia induction. A detailed evaluation of the patient’s medical history and subsequent diagnostic imaging examinations indicated achalasia. She was treated for aspiration pneumonia for 2 weeks. After 2 months, rescheduled total knee arthroplasty was performed under spinal anesthesia without any complications. CONCLUSIONS: Obtaining the patient’s medical history and assessing the risk factors are important to prevent unpredictable intraoperative pulmonary aspiration. High-risk patients should undergo adequate preoperative fasting and regional anesthesia or rapid-sequence intubation should be considered for safe induction of general anesthesia. Korean Society of Anesthesiologists 2022-04-30 2022-03-08 /pmc/articles/PMC9091672/ /pubmed/35280041 http://dx.doi.org/10.17085/apm.21102 Text en Copyright © the Korean Society of Anesthesiologists, 2022 https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Airway Management
Kim, Hee Jung
Choi, Yong Seon
Jin, Jeong Hyun
Lee, Bora
Management of pulmonary aspiration due to undiagnosed achalasia during induction of general anesthesia - A case report -
title Management of pulmonary aspiration due to undiagnosed achalasia during induction of general anesthesia - A case report -
title_full Management of pulmonary aspiration due to undiagnosed achalasia during induction of general anesthesia - A case report -
title_fullStr Management of pulmonary aspiration due to undiagnosed achalasia during induction of general anesthesia - A case report -
title_full_unstemmed Management of pulmonary aspiration due to undiagnosed achalasia during induction of general anesthesia - A case report -
title_short Management of pulmonary aspiration due to undiagnosed achalasia during induction of general anesthesia - A case report -
title_sort management of pulmonary aspiration due to undiagnosed achalasia during induction of general anesthesia - a case report -
topic Airway Management
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9091672/
https://www.ncbi.nlm.nih.gov/pubmed/35280041
http://dx.doi.org/10.17085/apm.21102
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