Bilateral tension pneumothorax caused by an abrupt increase in airway pressure during cervical spine surgery in the prone position-A case report-

Abstract

Elevated peak inspiratory airway pressure (PIP) can occur during general anesthesia and is usually easily rectifed. In rare circumstances it can lead to potentially fatal conditions such as tension pneumothorax. We report on a 77-year-old male patient admitted for a cervical laminoplasty. The preoperative chest radiograph showed normal fndings and there was no medical history of allergy or underlying airway infammation. Anesthesia induction and maintenance progressed uneventfully. However, 5 minutes after prophylactic antibiotic administration, PIP suddenly increased and blood pressure dropped. The operation was abandoned and the patient was moved to a supine position to perform chest radiography. Cardiac arrest occurred, and cardiopulmonary resuscitation was performed. Te radiograph showed bilateral tension pneumothorax. Needle aspiration was immediately performed, and chest tubes were inserted. Ventilation rapidly improved and the vital signs normalized. Te patient was discharged without sequelae on postoperative day 36. © the Korean Society of Anesthesiologists, 2011.