Acute Pulmonar Edema during General Anesthesia / 대한마취과학회지

ABSTRACT

The authors have experienced, during general anesthesia with methoxyflurane-nitrous oxide- oxygen for explorative laparatomy to perform appendectomy, a case of acute pulmonary edema, which is rare and it's etiology is various. The patient had no specific past or family history and the only predisposing factor was myocardial ischemia caused by cardio-vascular collapse due to severe dehydration. In this case, the authors believed that pre-existing myocardial ischemia, rapid transfusion of 5% dextrose and myocardial depressants (methoxyflurane and d-tubocurarine) were the causative factors. For this reason at least, myocardial depressants should be avoided in severely dehydrated patients. There are many preventive measures and treatments for acute pulmonary edema during general anesthesia. As in this case, we believe that prompt recognition and attention by the anesthesiologists are the most important preventive and therapeutic measures.