[A case of pulmonary edema following upper airway obstruction after general anesthesia]

A 30-year-old man underwent tonsillectomy and laryngomicrosurgery under nitrous oxide oxygen-isoflurane anesthesia. Preoperative physical examinations and interview revealed no cardiopulmonary abnormalities. Two minutes after extubation, he showed dyspnea with marked inspiratory efforts and cyanosis due to laryngeal spasm. The SpO2 decreased from 100% to 80%. He was reintubated after administration of suxamethonium 100 mg and ventilated with 100% oxygen. At that time pink frothy sputum came out from his airway. He was diagnosed as pulmonary edema from analysis of arterial blood gases and chest X-ray. He received mechanical ventilation with positive end-expiratory pressure in the ICU. Twenty hours later the pulmonary edema was improved and he was extubated uneventfully. He was discharged from the hospital on the 8th post-operative day. We reported a case of pulmonary edema after laryngeal spasm. It was suggested that a patient after acute upper airway obstruction should be carefully treated considering secondary pulmonary edema.