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Anaesthesia
Vocal cord dysfunction causing hypoxaemia in the postanaesthesia care unit
  1. Kristin Anne de Vries1,
  2. Aukje van der Wolk2,
  3. Jantine Venker3 and
  4. Jasper Koolwijk1
  1. 1Anesthesiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands
  2. 2ICU, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands
  3. 3ENT, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands
  1. Correspondence to Kristin Anne de Vries; k.devries{at}amsterdamumc.nl

Abstract

Hypoxaemia in the postanaesthesia care unit is common and the majority is caused by hypoventilation or upper airway obstruction due to the (residual) effects of anaesthetic and analgesic agents. We present a case of upper airway obstruction caused by vocal cord dysfunction, a less frequently occurring aetiology. The patient’s case suggests a notable relationship between procedural laryngeal stimulus and the onset of symptoms. Approach to the diagnosis and flexible laryngoscopy to either rule-in or rule-out several relevant differentials are discussed.

  • anaesthesia
  • ear, nose and throat/otolaryngology
  • intensive care

https://doi.org/10.1136/bcr-2023-257685

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: KAdV, JK, JV and AvdW. The following authors gave final approval of the manuscript: KAdV, JK, JV and AvdW.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.