A & A case reports
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Two anesthesia cases are presented involving patients with a history of posttraumatic stress disorder (PTSD). The first patient experienced a prolonged dangerous flashback during emergence. In the second patient, after a thorough review of PTSD and the anesthesia literature, emergence was uneventful. A history of PTSD should be considered a risk factor in the assessment of every patient and anesthetic management designed to best avoid serious and potentially harmful reactions.
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After standard hip arthroplasty, an 82-year-old patient with previously undiagnosed diffuse idiopathic skeletal hyperostosis of the cervical spine experienced life-threatening side effects after use of a supraglottic airway device (i-gel). Extensive mucosal erosion and denudation of the cricoid cartilage caused postoperative supraglottic swelling and prolonged respiratory failure requiring tracheostomy. In this case report, we highlight the importance of evaluating risk factors for failure of supraglottic airway devices.
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A fiberoptic examination is recommended at the end of lung transplantation for bronchial toilet and to check the bronchial anastomoses. This procedure permitted detection of a 10 × 4-mm piece of plastic of unknown origin in the left lingular bronchus and suggests that bronchoscopy should be performed before implanting the transplanted lung.
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We describe a case of extensive soft palate ulceration after the use of an i-gel supraglottic airway device (Intersurgical Ltd, Wokingham, United Kingdom) during a knee arthroscopy in a 61-year-old man. He presented with pain and soft palate ulceration, which eventually required hospital admission because of dehydration. The pharynx healed completely within 3 months, with a change in taste as the remaining symptom.