Diagnostic value of visual stethoscopes for detecting bronchospasm in a patient under general anesthesia - A case report

Abstract

Background: Bronchospasm is a rare but potentially life-threatening complication during anesthesia that requires prompt recognition and management. Traditional auscultation plays a key role but is limited in objective interpretation and continuous monitoring.

Case: We report a case of intraoperative bronchospasm during laparoscopic surgery, detected early through real-time acoustic visualization using a digitalized esophageal stethoscope. The visualization of lung sounds facilitated the rapid identification of expiratory wheezing and abnormal spectrogram patterns characteristic of bronchospasm. Immediate intervention with a bronchodilator resolved the condition without further complications.

Conclusions: This case demonstrates the utility of visual stethoscopes in enhancing perioperative respiratory management. Real-time visualization and quantification of lung sounds offer anesthesiologists a valuable tool for early diagnosis and collaborative decision-making during critical respiratory events.

Keywords: Acoustic signal; Bronchial spasm; Esophageal stethoscopes; Medical devices; Physiologic monitoring; Sound; Spectrograms.

Fig. 1.

Visual stethoscope signal, end-tidal CO₂, airway pressure, and spectrogram. The left panel illustrates a sudden episode of bronchospasm, showing a high-frequency band in the visual stethoscope signal and spectrogram. The right panel shows recovery following bronchodilator treatment, with the disappearance of the high-frequency band in the visual stethoscope signal and spectrogram. Notably, end-tidal CO₂ and airway pressure returned to normal ranges within 30 min.

Fig. 2.

Serial chest radiographs of the patient. (A) The perioperative radiograph shows normal findings. (B) On postoperative day 2, a slight left pleural effusion and subsegmental atelectasis are observed. (C) At the 2-month outpatient follow-up, the pleural effusion and atelectasis have resolved.