[Bronchospasm during crush induction with propofol under the Sellick maneuver in a patient for emergency laparotomy]

A 61-year-old man was scheduled for an emergency laparotomy due to ileus. He had a history of asthma, but it was well controlled without medication. Anesthesia was induced with propofol and ketamine under the Sellick maneuver. Following administration of vecuronium, endotracheal intubation was performed. However, he could not be ventilated. We thought that the tube had been inserted into the esophagus, and re-intubation was performed. However he could not be ventilated as in the first trial. At that time, we suspected that bronchospasm had occurred. Bronchospasm improved rapidly using hyperventilation with 100% oxygen and 3-5% sevoflurane, and intravenous aminophylline. Because he had a history of asthma, propofol was relatively indicated from the point of smooth muscle relaxant effects. However we should consider the risk of bronchospasm in a patient with a history of asthma, even if we use propofol.