Pneumonia from pulmonary aspiration of an antihypertensive anesthetic premedication: A case report

ABSTRACT

A 75-year-old man was scheduled for a ray amputation of the left third metatarsal bone. He had a right middle cerebral artery (MCA) territory infarction 6 months earlier and had a history of dysphagia and repeated pneumonias. At 06:30 on the day of surgery, nifedipine was administered orally with small amounts of water and the patient coughed several times. Immediately after extubation at the end of anesthesia, an impacted drug-like material was noted in the endotracheal tube. It is likely that aspiration occurred at the time nifedifine was ingested the morning of surgery. The route of administration for premedications, should be modified when patients have perioperative risk factors for pulmonary aspiration.