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Laryngospasm, an occlusion of the glottis, can occur at any time during anesthesia, and is associated with serious perioperative complications such as hypoxia, hypercabia, aspiration, bronchospasm, arrhythmia, prolonged recovery, cardiac collapse, and eventually catastrophic death. Importantly, postoperative negative pressure pulmonary edema (NPPE) is a rare, but well described life-threatening complication related to acute and chronic upper airway obstruction. Sugammadex well known for affirmatively reducing the postoperative pulmonary complications associated with residual neuromuscular blockade may have an indirect role in triggering the negative intrathoracic pressure by raising a rapid and efficacious respiratory muscle strength in acute upper airway obstruction. Herein, we report a case of postoperative NPPE following repetitive laryngospasm even after reversal of rocuronium-induced neuromuscular blockade using sugammadex.
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http://dx.doi.org/10.4097/kjae.2017.70.1.95 | DOI Listing |
Perioper Care Oper Room Manag
September 2025
Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
Background: Postoperative pulmonary complications including atelectasis are common complications after surgery. However, the incidence of postoperative atelectasis in pediatric surgical population is not yet well delineated.
Methods: Using electronic medical record, we identified pediatric patients who underwent gastrointestinal surgery from January 2016 to September 2019 and determined the presence or absence of postoperative atelectasis by postoperative X-ray read.
Eur J Anaesthesiol
September 2025
From the Department of Anaesthesiology, Antwerp University Hospital, Edegem, Faculty of Medicine and Health Science, University of Antwerp, Antwerp (VS), UCLouvain Medical School, Brussels, Belgium (FV) and Department of Anaesthesiology and Intensive Care, Akershus University Hospital, Lørenskog, I
Neuromuscular blocking agents (NMBAs) are critical components in paediatric anaesthesia, facilitating intubation, surgical procedures and mechanical ventilation in neonates, infants and children. This narrative review examines the pharmacological properties, clinical applications, monitoring, reversal and safety of NMBAs across paediatric populations. Given the unique physiological characteristics of neonates and infants - including hepatic and renal maturation, and neuromuscular junction development - NMBA metabolism, efficacy and adverse effects in these age groups differ markedly from those in older children and adults.
View Article and Find Full Text PDFJ Exp Clin Cancer Res
September 2025
Molecular Immunology Unit, Experimental Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori di Milano, Milan, Italy.
Background: High-grade breast cancer (HGBC) is an aggressive disease with poor prognosis, underscoring the need for new treatment strategies. The tumor microenvironment (TME), particularly the extracellular matrix (ECM), plays a pivotal role in tumor progression, therapy resistance, and immune regulation. An ECM-related gene signature (defined ECM3), found in approximately 35% of HGBC cases, is associated with aggressive tumors, epithelial-to-mesenchymal transition (EMT), poor clinical outcome and increased infiltration of immunosuppressive myeloid-derived suppressor cells (MDSCs).
View Article and Find Full Text PDFTrials
August 2025
Queen Mary University of London, London, UK.
Background: Post-operative pulmonary complications (PPCs) are an important source of morbidity and mortality after major abdominal and thoracic surgery. The use of neuromuscular blocking drugs in general anaesthesia is an important risk factor for PPCs. The incomplete reversal of this neuromuscular blockade at the end of surgery leads to residual weakness of respiratory muscles and predisposes to aspiration of pharyngeal contents, hypoventilation, and thus to PPCs such as atelectasis and pneumonia.
View Article and Find Full Text PDFLife (Basel)
August 2025
Department of Anesthesiology and Intensive Care, County Emergency Clinical Hospital of Târgu Mureș, 540136 Târgu Mureș, Romania.
Preeclampsia with severe features presents major anesthetic challenges, particularly in category 1 cesarean sections, in which rapid, safe, and hemodynamically stable induction is critical. Neuraxial techniques may be controversial due to neurological symptoms, making general anesthesia a viable option. However, traditional general anesthesia may exacerbate hypertension and increase maternal and fetal risks.
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