Possible Ketorolac-Induced Bronchospasm In Obese Patient With Undiagnosed Asthma

Proposal Number:

MCC-7155 

Proposal Type:

Medically Challenging Case Report Poster 

Author:

Neel Patel  
Rutgers Robert Wood Johnson Medical School

Co-Author(s):

Danielle Levin  
St. Elizabeth's Medical Center
James Tse  
Rutgers Robert Wood Johnson Medical School

Abstract:

A 58 y/o obese female (BMI 47 kg/m2) who denied asthma, recent URI and OSA presented for hysteroscopy. GA induction/video-laryngoscopy intubation was smooth with nasal pressure-control ventilation. She maintained 100%SpO2 under sevoflurane/50% N2O. Upon emerging, 30mg ketorolac was given. She became agitated 15-20 mins later and desaturated to 70-80% with moderate wheezing. It was resolved with albuterol inhalation (3 puffsx4) and 2% lidocaine spray (3ccx2) via endotracheal tube. Her SpO2 increased to 98%. She was extubated without further problem. Her spouse admitted that she had recent URI and 3-pillow orthopnea. Pulmonology consult revealed negative chest X-ray and ABG, and suggested discharge home and follow-up for adult-onset-asthma.

Professional Category:

Student

Keywords:

General
Other - Airway Management

Supporting Image: PGAHysterscopyAsthmaF1.jpg
   ·Monitor showing stable hemodynamics during hysteroscopy/D&C.
Supporting Image: PGAHysterscopyAsthmaF2.jpg
   ·Ketorolac (30 mg) was given at 1310.
Supporting Image: PGAHysterscopyAsthmaF3.jpg
   ·She developed bronchospasm and desaturated 15-20 mins following administration of ketorolac.
 

Enter up to two references.

  Reference
1. Anesth Analg 1993;76:420-2; 2. Am J Forensic Med Pathol 2008;29:358-63