Journal of Dental Anesthesia and Pain Medicine

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
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Pulmonary aspiration during intubation in a high-risk patient: A video clip and clinical implications

  • Koh, Gi-Ho (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kim, Sung-Hoon (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Son, Hyo-Jung (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Jo, Jun-Young (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Choi, Seong-Soo (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Park, Se-Ung (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kim, Wook-Jong (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Ku, Seung-Woo (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center)
  • Received : 2018.03.19
  • Accepted : 2018.03.28
  • Published : 2018.04.30
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Abstract

We report a case of pulmonary aspiration during induction of general anesthesia in a patient who was status post esophagectomy. Sudden, unexpected aspiration occurred even though the patient had fasted adequately (over 13 hours) and received rapid sequence anesthesia induction. Since during esophagectomy, the lower esophageal sphincter is excised, stomach vagal innervation is lost, and the stomach is flaccid, draining only by gravity, the patient becomes vulnerable to aspiration. As the incidence of perioperative pulmonary aspiration is relatively low, precautions to prevent aspiration tend to be overlooked. We present a video clip showing pulmonary aspiration and discuss the literature concerning the risk of aspiration and its preventive strategies.

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References

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