Author/Authors :
Arai، Young-Chang P. نويسنده Multidisciplinary Pain Centre, School of Medicine, Aichi Medical University, Aichi, Japan , , Kawanishi، Jun نويسنده Department of Surgery, Toki General Hospital, Gifu, Japan , , Sakakima، Yoshikazu نويسنده Department of Surgery, Toki General Hospital, Gifu, Japan , , Ohmoto، Koichi نويسنده Department of Surgery, Toki General Hospital, Gifu, Japan , , Ito، Akihiro نويسنده , , Maruyama، Yuki نويسنده Department of Surgery, Toki General Hospital, Gifu, Japan , , Ikemoto، Tatsunori نويسنده Multidisciplinary Pain Centre, School of Medicine, Aichi
Medical University, Aichi, Japan ,
Abstract :
Pulmonary collapse after intubation is common, and it is caused by a variety of factors. A 21-year-old man presented at our operation room to undergo an appendectomy. Except for a history of cigarette smoking, his history was negative. Anesthesia was induced with 100% oxygen and sevoflurane, remifentanil infusion, and propofol. Neuromuscular block was obtained with rocuronium. The tip and cuff of a tracheal tube were lubricated with a topical metered-dose of 8% Lidocaine pump spray. After intubation, SPO2 suddenly decreased. The chest x-ray revealed right upper lobe atelectasis. Fiber optic bronchoscopy showed that a large amount of yellow sticky mucus had been secreted into the right main bronchus. In Japan, 8% Lidocaine pump spray contains menthol and ethanol as additives. These additives, particularly menthol, might have led to excessive mucus production, although we did not analyze the mucus secretion.
