[Case of laryngeal edema occurring after tracheal extubation presumably due to antihypertensive medications]

Abstract

A 61-year-old woman underwent microlaryngeal surgery for a vocal cord polyp. Anesthesia was induced with propofol, and vecuronium was given after loss of consciousness. The trachea was intubated smoothly with a Portex tracheal tube with a 6.0 mm in inner diameter and the cuff was inflated to the minimal occlusion volume. Anesthesia was maintained with O2-air-sevoflurane. The surgical procedure was completed without any troubles. Immediately after tracheal extubation, she developed dyspnea with stridor. As marked laryngeal edema was found by direct vision with the aide of a laryngoscope, reintubation was performed and methylprednisolone was administered intravenously. She was extubated on the next day, after confirmation of the tracheal tube cuff leak following the reduction in the cuff pressure. At this time, fiberoptic bronchoscopy revealed that the laryngeal edema had disappeared. For the past history, she had taken amlodipine for 10 years and candesertan for 2 months, and had often experienced dyspnea. It should be kept in mind that preoperative antihypertensive medications might have an impact on occurrence of perioperative laryngeal edema.