Sun Xiaodi, Dai Leyang, Pan Yinbing, Sha Huanhuan
Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing Jiangsu, P.R. China.
Medicine (Baltimore). 2020 May 22;99(21):e20363. doi: 10.1097/MD.0000000000020363.
Parkinson disease (PD) is a chronic neurodegenerative condition often suffered by the elderly. Upper airway obstruction, though rare in patients with PD, can be life threatening and is associated with vocal cord paralysis, laryngeal spasm, and dystonia of jaw and neck muscles.
We describe a life-threatening upper airway obstruction caused by bilateral vocal cord paralysis, in an elderly man with PD, during extubation after general anesthesia.
Based on clinical presentation and visual laryngoscopy, the patient was diagnosed with laryngeal spasm and bilateral vocal cord paralysis after extubation.
Re-intubation was carried out and dopamine hydrazine tablets were administered via a nasal feeding tube.
After re-intubation and further treatment, the endotracheal tube was successfully removed and no symptoms of respiratory distress were observed.
Patients with PD may be at a risk of life-threatening upper airway obstruction after extubation, which should be prevented systematically.
帕金森病（PD）是一种常见于老年人的慢性神经退行性疾病。上呼吸道梗阻在PD患者中虽罕见，但可能危及生命，且与声带麻痹、喉痉挛以及颌面部和颈部肌肉张力障碍有关。
我们描述了一名患有PD的老年男性在全身麻醉拔管期间，因双侧声带麻痹导致危及生命的上呼吸道梗阻。
根据临床表现和喉镜检查，患者被诊断为拔管后喉痉挛和双侧声带麻痹。
进行了再次插管，并通过鼻饲管给予多巴胺肼片。
再次插管并进一步治疗后，气管导管成功拔除，未观察到呼吸窘迫症状。
PD患者拔管后可能面临危及生命的上呼吸道梗阻风险，应进行系统预防。
