Abstract:
:We report a severe unilateral recurrent laryngeal nerve neuropraxia following use of the ProSeal laryngeal mask airway (PLMA) in a 71-year-old female patient with CREST syndrome. She required amputation of the 5th phalanx of foot because of gangrene due to Raynaud's syndrome. Anesthesia was induced with propofol, and a size 3 PLMA was inserted. Anesthesia was maintained with sevoflurane and nitrous oxide for 2 h and the operation was performed uneventfully. On removal of PLMA, the cuff volume was measured to 40 ml. The patient did not complain of respiratory discomfort shortly after PLMA removal. However, the next day she developed dysphagia and hoarseness. Laryngoscopic examination revealed unilateral vocal cord paralysis. Cricothyrotomy was required because of suspected silent aspiration pneumonia. The pharyngolaryngeal complications improved with a mobile vocal cord but slight hoarseness after 2 months. We considered the patient's CREST syndrome with a potential of tissue ischemia, and the high intracuff pressure of the PLMA due to nitrous oxide influx, to be the cause of severe recurrent laryngeal nerve neuropraxia in this case.
journal_name
Acta Anaesthesiol Scandjournal_title
Acta anaesthesiologica Scandinavicaauthors
Kawauchi Y,Nakazawa K,Ishibashi S,Kaneko Y,Ishikawa S,Makita Kdoi
10.1111/j.1399-6576.2005.00616.xsubject
Has Abstractpub_date
2005-04-01 00:00:00pages
576-8issue
4eissn
0001-5172issn
1399-6576pii
AAS616journal_volume
49pub_type
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journal_title:Acta anaesthesiologica Scandinavica
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journal_title:Acta anaesthesiologica Scandinavica
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更新日期:2000-04-01 00:00:00
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更新日期:2001-02-01 00:00:00