Subanaesthetic sevoflurane by a helmet for bronchospasm after tracheal extubation.

摘要

We would like to report a case of successful treatment of bronchospasm after tracheal extubation with sub-anaesthetic sevoflurane delivered by a helmet. A 59-yr-old female was undergoing elective laparoscopic adrenalect-omy for a 7 mm tumour. The patient was taking pantopra-zole for gastro-oesophageal reflux disease and had no history of asthma or allergy to medication. After induction of general anaesthesia, the anaesthetist intubated the trachea (Cormack and Lehane Grade IIIA) at the third attempt and after the insertion of a Frova airway intubating introducer® (Cook Critical Care, Bjaeverskov, Denmark). Some clear liquid was sucked out from the mouth and the trachea, suggesting that pulmonary aspiration may have occurred and a 16 Salem gastric tube was introduced into the stomach. Anaesthesia was maintained with sevoflurane 1-1.4% and nitrous oxide 65% in oxygen. Fentanyl and vecuronium were administered i.v. to ensure analgesia and muscle relaxation. Ranitidine 100 mg and methylpredniso-lone 125 mg were given i.v. to reduce gastric secretion and bronchial hyperreactivity. No wheezing was audible during anaesthesia.