International Medical Case Reports Journal (Oct 2021)

Anesthetic Care During Tracheostomy in a Patient with Generalized Tetanus: A Case Report

  • Yoshida M,
  • Yamaguchi Y,
  • Matsushita M,
  • Tsuboi S,
  • Sugawara Y,
  • Hayami H,
  • Tobias J,
  • Inagawa G

Journal volume & issue
Vol. Volume 14
pp. 735 – 738

Abstract

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Megumi Yoshida,1 Yoshikazu Yamaguchi,1 Mizuho Matsushita,1 Sayaka Tsuboi,1 Yoh Sugawara,1 Hajime Hayami,1 Joseph Tobias,2 Gaku Inagawa1 1Department of Anesthesiology, Yokohama Municipal Citizen‘s Hospital, Yokohama, Japan; 2Department of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital and The Ohio State University, Columbus, OH, USACorrespondence: Megumi YoshidaYokohama Municipal Citizen’s Hospital, 1-1 Mitsuzawanishimachi, Kanagawa-ku, Yokohama, 221-0855, JapanTel +81 45 316-4580Fax +81 45 316-6580Email [email protected]: Tetanus is a potentially fatal infectious disease caused by the toxins produced by the anaerobic bacterium, Clostridium tetani. Of major concern during the perioperative care of these patients is control of muscle spasms, skeletal rigidity, and autonomic dysfunction. Several of the modern sedative and opioid agents including remifentanil have not been fully evaluated in managing tetanus. We present the intraoperative use of remifentanil in a 75-year-old woman with generalized tetanus who required anesthetic care during placement of a tracheostomy. The end-organ involvement of tetanus is presented, previous reports of anesthetic care reviewed, and the potential utility of remifentanil explored.Keywords: tetanus, tracheostomy, general anesthesia

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