Laryngospasm and Negative Pressure Pulmonary Edema

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A 44-year-old woman with a history of breast cancer came to the hospital for stage II of a breast reconstruction procedure.

Induction and intubation were uneventful.

Standard anti-emetics and pain medicines were given.

Her vitals remained stable throughout the case.

At the conclusion of the case the patient was extubated.

The anesthesiologist applied the circuit mask and noted the absence of end tidal CO2.

She immediately suspected a laryngospasm.

After those 15-20 seconds without successful ventilation, she called for help to the room and gave 20mg of succinylcholine.

A second anesthesiologist arrived and assisted in masking the patient until the patient began taking breaths on her own.

She was then brought to PACU.

In PACU she was given a basin for the copious bloody sputum she was coughing up.

She was also given supplemental oxygen and IV Lasix.

Room air sat was in the 80s, so she was admitted overnight for monitoring and supplemental oxygen.

The patient and her fiancé were advised about the events that transpired on multiple occasions.

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