Identification of the presence of chronic obstructive pulmonary disease in the elderly patients who was scheduled for surgery is vitally important. If appropriate therapeutic and preventive measures should not be instituted, tracheal intubation
of
the
patient should be associated with a number of complications.
@EN We experienced a case of acute attack of asthma and pulmonary collapse during endotracheal intubation. A 54-year-old male who was scheduled for an emergency of primary corneo-scleral suture have had history of bronchial asthma. On the
preoperative
physical examination. There was no specific finding except expiratory wheezing. After endotracheal intubation with the aid of ketamine 2 mg/kg, pancuronium bromide 0.1 mg/kg and lidocaine 2 mg/kg, iv, acute asthmatic attack was appeared.
Breathing
sounds on the both lung fields can not be audible during manual ventilation and SpO2 was dropped to 70% at F1O2 1.0. To relieve asthmatic attack, epinephrine(1:1.000) 0.5 ml, sc aminophylline 4 mg/kg, iv and methyprednisolone 1 mg/kg, iv were
injected.
Erosion of tracheal mucosa, blood clots and mucous plugs were found by the fibroptic bronchoscopy. After removal of blood clots and mucus, lung complicance and SpO2 were improved. The patient was discharged 7 days later without any complications
or
sequelae.
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