Trismus during tracheal extubation as a complication of general anaesthesia – A case report

Author:

Radkowski Paweł123,Kędziora Bartosz2,Dawidowska-Fidrych Justyna4

Affiliation:

1. Department of Anaesthesiology and Intensive Care, Regional Specialist Hospital in Olsztyn , Olsztyn , Poland

2. Department of Anaesthesiology and Intensive Care, Faculty of Medicine, Collegium Medicum University of Warmia and Mazury in Olsztyn , Olsztyn , Poland

3. Department of Anaesthesiology, Intensive Care and Emergency Medicine, Hospital Zum Heiligen Geist in Fritzlar , Fritzlar , Germany

4. Department of Paediatrics, Pro-Medica Hospital in Ełk , Ełk , Poland

Abstract

Abstract Tracheal extubation is a risky phase of anaesthesia. Most complications that occur when an endotracheal tube is removed are of minor nature, but those that require critical action can end in serious complications or even death. Patient – A 55-year-old woman was admitted for elective transabdominal hysterectomy and adnexal procedures. Anaesthesia – Standard monitoring. For induction, we used fentanyl, propofol, and rocuronium. The maintenance phase of anaesthesia was without complications. After extubation, the patient presented with severe trismus and mask ventilation was unsuccessful (cannot ventilate) – It was not until 200 mg of succinylcholine was administered that the masseter muscle spasm subsided. Extubation is a process that must always be planned. A routine approach and lack of a contingency plan is responsible for a number of complications related to the period of patient awakening and associated with the removal of the endotracheal tube. Trismus, in response to extubation, is a phenomenon not described in the literature in non-high risk patients.

Publisher

Walter de Gruyter GmbH

Subject

General Medicine

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