N egative pressure pulmonary edema is an uncommon complication of extubation of the trachea (>0.1%) mostly caused by laryngospasm (1). Upper airway obstruction from glottis closure leads to marked inspiratory efforts, which generate very negative intrathoracic pressure. This may cause pulmonary edema (1,2) and, rarely, hemoptysis (3,4). This report is the first to document both bronchoscopic an...

This case report presents a 67-year-old female with Parkinson’s disease who underwent deep brain stimulation (DBS) electrode replacement surgery. Following extubation, the patient developed persistent laryngospasm, requiring immediate intervention. Suspecting symptoms similar to levodopa withdrawal, received intravenous propofol and enteral supplementation, leading symptom improvement. The unde...

The refraction of a localized narrow beam is significantly different from that of a plane wave. As the beam width decreases to be in the order of the wavelength, the refraction behavior deviates noticeably from Snel’s law, and when the width of a light beam is smaller than about one fifth of the wavelength of the incident light, finite-difference time-domain simulations demonstrate that refract...

THE anesthesia literature is full of information and recommendations for safely administering general anesthesia to patients with various myotonic, neuromuscular, and vocal cord disorders; however, little is published on speech disorders and how these often vocal cord– related afflictions can influence anesthetic management. This report discusses an incident of laryngospasm in a patient with sp...

Flexible fibreoptic bronchoscopy is a safe procedure with a major complication rate of ,1% in most published studies [1]. In one retrospective study of .4,000 bronchoscopies, major complications (respiratory failure, pneumothorax and pulmonary haemorrhage of .50 mLs) occurred in 0.5% of procedures and minor complications (laryngospasm, vomiting, bronchospasm, vasovagal syncope and epistaxis) in...

Unexpected acute respiratory failure after anesthesia is a diagnostic challenge: residual neuromuscular blockade, bronchial hyperresponsiveness, laryngospasm, atelectasis, aspiration pneumonitis, and other more uncommon causes should be taken into account at diagnosis. Lung ultrasound and echocardiography are diagnostic tools that would provide the differential diagnosis. We report a suspected ...

Acute airway obstruction can result in life - threatening pulmonary edema. It can develop rapidly, without warning, in otherwise healthy patients. Negative pressure pulmonary edema has been described after acute airway obstruction in situations when a patient is breathing against an obstructed airway such as croup, epiglottitis or laryngospasm. In the following case, we observed a rare occurren...

Stimulation of laryngeal receptors is the natural starting point of defensive airway reflexes including the cough reflex, expiration reflex, spasmodic panting, and apnoea with laryngospasm. Although several different types of laryngeal receptors have been reported, the laryngeal irritant receptors are considered to play the most essential role in elicitation of defensive airway reflexes. Based ...

PURPOSE The purpose of this study was to determine the effect-site concentration (Ce) of remifentanil in 50% of patients (EC₅₀) and 95% of patients (EC₉₅) for smooth laryngeal mask airway (LMA) removal in adults under propofol and remifentanil anesthesia. MATERIALS AND METHODS Twenty-five patients of ASA physical status I-II and ages 18-60 years who were to undergo minor gynecological or orth...

EDITOR: Negative pressure pulmonary oedema is a medical emergency that usually arises from attempted ventilations against an acutely obstructed upper airway, such as the one that occurs during laryngospasm, resulting in transudation of fluid from pulmonary capillaries to the interstitium. Frequently, this occurs in the perioperative period when general anaesthesia is used. Clinicians should pro...