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.