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Asymptomatic diaphragmatic defect--a post-operative problem
Canadian Anaesthetists' Society Journal
|March 1, 1978
Summary
A large diaphragmatic defect caused lung compression during surgery. Post-operative shivering exacerbated symptoms, but gastric aspiration provided rapid relief, highlighting the need for proactive patient support.
Area of Science:
- Medical Anesthesia
- Thoracic Surgery
- Diaphragmatic Surgery
Background:
- Unrecognized large diaphragmatic defects can lead to intraoperative complications.
- Nitrous oxide anesthesia with narcotic supplementation was used during a maxilla operation.
Observation:
- The patient developed near-complete left lung compression due to the diaphragmatic defect.
- Post-operative shivering increased metabolic demand, causing air hunger.
Findings:
- Aspiration of gastric gas promptly resolved the patient's respiratory distress.
- Significant residual X-ray findings were noted despite clinical improvement.
Implications:
- The early post-operative period is metabolically demanding, not restful.
- Identify and support high-risk patients pre-operatively with ventilatory assistance and metabolic support.