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    e-Posters
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Purpose: The incidence of bronchospasm during the perioperative period has been associated with IgE-mediated anaphylaxis or may occur as an independent clinical entity caused by mechanical or pharmacological factors, or even underlying airway hyperreactivity. Hyperreactive airway disease occurs due to acute viral or bacterial infections and refers to patients leading to higher airway response to any physical, chemical or pharmacological stimuli to the airway. COVID-19 disease may be such a predisposing factor. We present a case of severe bronchospasm during induction of general anaesthesia for emergency surgery at an asymptomatic COVID-19+ patient.
Case report: A 35-year-old woman, with abdominal pain, presented at the emergency department, and diagnosed with acute appendicitis. She was an active smoker with a BMI of 35,2 kg/m2. During preoperative evaluation, she tested positive for SARS-CoV-2, although asymptomatic. Her past medical history was unremarkable, with not known allergies or coexisting diseases. After induction of general anaesthesia and subsequent endotracheal intubation, EtCo2 was increased and desaturation occurred rapidly. Bronchospasm was suspected by auscultation, decreased lung compliance and high airway peak pressures. Hydrocortisone, aminophylline and epinephrine were administered subsequently intravenously, as well as nebulised salbutamol. She responded very slowly, but finally the bronchospasm was reversed and surgery was completed. The patient was successfully extubated and was discharged from the Post-Anaesthesia Care Unit after 2 hours.
Conclusion: Predisposing factors for respiratory complications should be considered thoroughly prior induction of anaesthesia. The data concerning COVID-19 is continuously changing; therefore, all positive patients have the potential of major anaesthetic complications -especially respiratory- and special attention should be addressed, even if the patient is asymptomatic.
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         SEVERE BRONCHOSPASM IN AN ASYMPTOMATIC COVID-19 POSITIVE PATIENT AFTER INDUCTION OF GENERAL ANAESTHESIA
Efstathia Pistioli1, Maria Tzoufi1, Chrysanthi Batistaki1, Paraskevi Matsota1
1 2nd Department of Anaesthesiology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” University Hospital, Athens, Greece
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