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Bronchial spasm during general anaesthesia

Summary

Two cases of severe bronchial spasm in patients under general anaesthesia are presented. In the first case the bronchial spasm, according to our clinical impression, was due to histamine release following a rapid intravenous injection of 15 mg of d-tubocurarine; 100 mg of lignocaine, administered intravenously, abolished the spasm. In the second case the spasm was induced reflexly by the intubation of the trachea in a patient under thiopentone anaesthesia; 40 mg of procaine, intravenously, ended the attack. The possible mechanisms by which local anaesthetic drugs may induce relaxation of the bronchial muscle are discussed.

Résumé

Nous avons présenté deux cas de spasme bronchique grave chez des malades sous anesthésie générale. Dans le premier cas, c’est notre diagnostic clinique, le spasme bronchique a été causé par une décharge ďhistamine à la suite de ľinjection rapide de 15 mg de d-tubocurarine par voie endoveineuse; ce spasme a cédé après ľinjection de 100 mg de lignocaïne. par voie endoveineuse. Dans le second cas, nous avons attribué le spasme à un réflexe provoqué par ľintubation endotrachéale chez un malade anesthésié au thiopentone; tout est entré dans ľordre après ľinjection de 40 mg de procaine par voie endoveineuse. Nous avons discuté les mécanismes possibles par lesquels les anesthésiques locaux peuvent faire céder le spasme de la musculature bronchique.

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Correspondence to Victor Brandus, Sarah Joffe, Charles V. Benoit or William I. Wolff.

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Brandus, V., Joffe, S., Benoit, C.V. et al. Bronchial spasm during general anaesthesia. Can. Anaesth. Soc. J. 17, 269–274 (1970). https://doi.org/10.1007/BF03004606

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Keywords

  • Thiopentone
  • Lignocaine
  • Procaine
  • Rheumatic Heart Disease
  • Right Bundle Branch Block