Post tracheal extubation stridor

Hollister, Nigel; Altemimi, Harith; West, Martyn

doi:10.1136/bcr.06.2011.4374

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…Nigel et al [ 20 ] have also reported that the presence of unrecognized contralateral recurrent laryngeal nerve palsy owing to cancer in a female patient had a postextubation stridor after an interscalene block with 30 mL of 0.375% bupivacaine combined with general anesthesia. The oxygen saturation in that previous patient decreased from 99% to 82%, and required reintubation and eventually a tracheostomy.…”

Section: Discussionmentioning

confidence: 99%

Delayed bilateral vocal cord paresis after a continuous interscalene brachial plexus block and endotracheal intubation

Park

Kim

et al. 2017

Medicine

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Rationale:Recurrent laryngeal nerve block is an uncommon complication that can occur after an interscalene brachial plexus block (ISB), which may lead to vocal cord palsy or paresis. However, if the recurrent laryngeal nerve is blocked in patients with a preexisting contralateral vocal cord palsy following neck surgery, this may lead to devastating acute respiratory failure. Thus, ISB is contraindicated in patients with contralateral vocal cord lesion. To the best of our knowledge, there are no reports of bilateral vocal cord paresis, which occurred after a continuous ISB and endotracheal intubation in a patient with no history of vocal cord injury or surgery of the neck.Patient concerns:A 59 year old woman was planned for open acromioplasty and rotator cuff repair under general anesthesia. General anesthesia was induced following an ISB using 0.2% ropivacaine and catheter insertion for postoperative pain control.Diagnoses:While recovering in the postanesthesia care unit (PACU), however, the patient complained of a sore throat and hoarseness without respiratory insufficiency. On the morning of the first postoperative day, she still complained of mild dyspnea, dysphonia, and slight aspiration. She was subsequently diagnosed with bilateral vocal cord paresis following an endoscopic laryngoscopy examination.Interventions:The continuous ISB catheter was immediately removed and the dyspnea and hoarseness symptoms improved, although mild aspiration during drinking water was still present.Outcomes:On the 4th postoperative day, a laryngoscopy examination revealed that the right vocal cord movement had returned to normal but that the left vocal cord paresis still remained.Lessons:When ISB is planned, a detailed history-taking and examination of the airway are essential for patient safety and we recommend that any local anesthetics be carefully injected under ultrasound guidance. We also recommend the use of low concentration of local anesthetics to avoid possible paralysis of the vocal cord.

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Section: Discussionmentioning

confidence: 99%

Delayed bilateral vocal cord paresis after a continuous interscalene brachial plexus block and endotracheal intubation

Park

Kim

et al. 2017

Medicine

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Prolonged dysphonia as a complication of interscalene block

Villar

Pacreu

Zalbidea

et al. 2015

Injury

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Assessment of the antimicrobial activity of potentially active substances (nanoparticled and non‐nanoparticled) against cheese‐derived micro‐organisms

Callaghan

Kerry

2014

Int J of Dairy Tech

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This study evaluated the antimicrobial potential of various naturally occurring substances, for use as active agents in cheese packaging. Sorbic acid and benzoic acid were examined as standard‐sized and nanoparticled solutions. Rosemary, curcumin and ascorbic acid were employed as nanoparticled solutions only, while non‐nanoparticled chitosan, of two molecular weights, were also selected for evaluation. All agents were assessed against micro‐organisms derived from cheese. Chitosan proved to be the most effective, with low molecular weight chitosan performing best. The most antimicrobial nanoparticle was found to be rosemary. Comparison of normal‐ and nanoparticle‐sized organic acid solutions showed little difference in terms of antimicrobial properties.

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Post tracheal extubation stridor

Cited by 3 publications

References 5 publications

Delayed bilateral vocal cord paresis after a continuous interscalene brachial plexus block and endotracheal intubation

Delayed bilateral vocal cord paresis after a continuous interscalene brachial plexus block and endotracheal intubation

Prolonged dysphonia as a complication of interscalene block

Assessment of the antimicrobial activity of potentially active substances (nanoparticled and non‐nanoparticled) against cheese‐derived micro‐organisms

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