Combined laryngospasm and bronchospasm during general anesthesia with i-gel® supraglottic airway: a case report

초록

Supraglottic airways (SGAs) are integral to airway management during general anesthesia. However, they can preci pitate serious airway complications such as laryngospasm and bronchospasm, particularly when anesthesia is light or airway irritation occurs. We report a rare case of concurrent laryngospasm and bronchospasm following i-gel (R) in sertion and describe the successful management. A 55-year-old male was scheduled for general anesthesia for carpal tunnel release. He was a chronic smoker but ha d no underlying systemic diseases. An i-gel (R) was inserted after standard induction. Approximately 10 minutes into t he surgery, the patient began to hiccup, followed by inadequate ventilation and loss of end-tidal CO2 tracing. Suspecting laryngospasm, the i-gel (R) was removed, and mask ventilation attempted. As ventilation remained poor, immediate endotracheal intubation was performed following succinylcholine administration. After intubation, severe wheezing was auscultated bilater ally, accompanied by low tidal volumes and high peak inspiratory pressures, consistent with bronchospasm. Intram uscular epinephrine was administered and resulted in rapid improvement in ventilation. Laryngospasm occurring d uring SGA use may concurrently trigger bronchospasm, warranting particular caution in smokers. This case undersc ores the importance of recognizing the complex nature of acute airway complications during SGA use and impleme nting prompt and appropriate management.

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