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[Unusual complication after hip surgery under spinal anesthesia]
R G Patrigeon1, E Combourieu, S Guérard
1Département urgences anesthésie-réanimation, hôpital d'instruction des armées Desgenettes, 69003 Lyon, France. RGFatF1@aol.com
Annales Francaises D'Anesthesie Et De Reanimation
|January 22, 2003
Summary
Elderly patients undergoing hip surgery may develop acute respiratory distress syndrome, often due to thromboembolism. This case highlights a rare complication: inhaled dental crown causing confusion and respiratory distress, mimicking other conditions.
Area of Science:
- Anesthesiology
- Pulmonology
- Gastroenterology
Background:
- Acute respiratory distress syndrome (ARDS) post-hip surgery in elderly patients typically suggests thromboembolism.
- Rarer complications, masked by anesthesia-induced behavioral changes, can be overlooked.
- Pre-existing chronic lung disorders increase risks associated with anesthetic complications.
Observation:
- A case of confusion following orthopedic surgery under spinal anesthesia was reported.
- The confusion masked a penetration syndrome caused by accidental inhalation of a dental crown.
- The patient's advanced age and chronic lung disease exacerbated the consequences of the inhalation.
Findings:
- Spinal anesthesia was chosen due to the patient's respiratory condition.
- The inhaled dental crown led to significant respiratory compromise.
- Bronchoscopic removal of the foreign body was successful under general anesthesia with spontaneous ventilation.
Implications:
- Highlights the importance of considering rare airway foreign body complications in elderly patients presenting with post-operative respiratory distress.
- Emphasizes that unusual neurological symptoms post-anesthesia may mask serious underlying conditions.
- Underscores the need for thorough diagnostic evaluation beyond common post-operative complications.