Case Report; PERIOPERATIVE BRONCOSPASM
Indrianto, Saleh Trisnadi

Anesthesiology Department, Faculty of Medicine, Universitas Islam Bandung
Anesthesiology Department, Al Ihsan Regional General Hospital West Java province

Abstract

Bronchospasm is a potentially serious problem encountered in perioperative who are undergoing general anesthesia. Bronchospasm that occurs is likely due to the respiratory tract that is still sensitive to inhalation after an infection, or spasm due to the release of histamine after administration of atracurium. In developing countries all over the world, the incidence of trauma due to traffic accidents is still high, especially limb trauma and head trauma in addition to multiple other traumas. A boy, age 13 years old, weight 48 kg, suffered a left thigh bone fracture, due to a traffic accident, planned to install plates and screws, through surgery with general anesthesia. The preoperative examination was obtained, GCS 15, history of accidents 4 days ago, history of respiratory tract infections that had healed 2 days ago, history of asthma (-), history of drug allergy (-), family history of asthma (+). Physical examination found: tension 115/74 mmHg, pulse 84x / min, respiration 18x / min, temperature afebrile. Laboratory blood tests are within normal limits. Induction was carried out by giving Fentanyl 50 mcg iv, Propofol 100 mg iv, Atracurium 20 mg iv, manually ventilated using O2, N2O, and sevoflurane gas. After 1 minute, the ventilation felt heavy, 20% SpO2, Tension 50/30 mmHg, pulse 130x / min, acral appeared cyanotic, immediately intubated with ETT no 6.5. Manual ventilation is still felt severe, 2 minutes later given bronchodilator Ventolin spray through ETT, Methylprednisolone 125 mg iv, Ephedrin 10 mg iv, Dexamethasone 4 mg iv. Manual ventilation continues, starting gradually becoming lighter, after 15 minutes, tension up 90/60 mmHg, pulse 120x / min, SpO2 95-97%, acral cyanosis (-). Conditions returned to normal, the operation continued with good results.

Keywords: bronchospasm - drug interventions - perioperative

Topic: Basic and Clinical Medical Sciences

Link: https://ifory.id/abstract-plain/YyzTRmeNv7qa

Web Format | Corresponding Author (Indrianto Indrianto Sp.An KIC)