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Anesthetic Care During Tracheostomy in a Patient with Generalized Tetanus: A Case Report
Megumi Yoshida1, Yoshikazu Yamaguchi1, Mizuho Matsushita1
1Department of Anesthesiology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan.
Abstract:
Tetanus is a potentially fatal infectious disease caused by the toxins produced by the anaerobic bacterium, Clostridium tetani. Of major concern during the perioperative care of these patients is control of muscle spasms, skeletal rigidity, and autonomic dysfunction. Several of the modern sedative and opioid agents including remifentanil have not been fully evaluated in managing tetanus. We present the intraoperative use of remifentanil in a 75-year-old woman with generalized tetanus who required anesthetic care during placement of a tracheostomy. The end-organ involvement of tetanus is presented, previous reports of anesthetic care reviewed, and the potential utility of remifentanil explored.
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