A 47-year-old woman underwent surgery of the cervical spine in the prone position. The patient was stable after the end of anaesthesia, ventilated spontaneously and complained of intense pain in the region of surgery. General anaesthesia was performed in a standard manner, and there were no unexpected abnormalities. Cormack-Lehane score by direct laryngoscopy was of I.
After administration of metamizole inspiratory dyspnea, anxiety and hypotension developed. Urgent reintubation was necessary – now by Cormack-Lehane score of IV. The patient was intubated with an endotracheal tube of size 7 using videolaryngoscopy. After that followed administration of catecholamine – noradrenaline (adrenalin was not administered), prednisolone 1000 mg i.v., dimetindene 4 mg and ranitidine 50 mg i.v. The patient was transferred to ICU while receiving analgosedation and mechanical ventilation. At admission to ICU, the patient´s hemodynamics was stable while supported with noradrenalin 0.4 mg/h. Mandatory ventilation followed without any problems. Soft oedema of the face, eyelids, lips and tongue developed. The patient continued to receive mechanical ventilation until the withdrawal of edemas.
Upper airways were examined using ultrasonography after approximately 12 hours: