Document Detail

Anesthetic management for laser excision of recurrent respiratory papillomatosis in a third trimester parturient.
MedLine Citation:
PMID:  16427531     Owner:  NLM     Status:  MEDLINE    
Recurrent respiratory papillomatosis (RRP) is characterized by the development of laryngeal papillomas, which can produce partial to complete upper airway obstruction. Patients with RRP often require intermittent surgical excision to treat symptoms such as hoarseness and stridor, and to control progression of the lesions. The anesthetic management of such patients is challenging, and it requires carefully coordinated care between an anesthesiologist and otolaryngologist. We present 2 cases of general anesthesia administration during surgical excision of laryngeal papillomas, both occurring during the third trimester of separate pregnancies in the same parturient. The complexity of management was amplified in these cases because of the physiological and anatomical changes associated with pregnancy, along with the need to monitor fetal well-being. Possible complications included complete airway obstruction, pulmonary aspiration of gastric contents, hypoxemia, fetal distress, and preterm labor. Because pregnancy may lead to activation of human papillomavirus, the causative organism of RRP, management guidelines are provided for anesthesiologists who may care for patients with RRP during pregnancy.
Paul A Tripi; Enas S Kandil; James E Arnold
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  17     ISSN:  0952-8180     ISO Abbreviation:  J Clin Anesth     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2006-01-23     Completed Date:  2006-04-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8812166     Medline TA:  J Clin Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  610-3     Citation Subset:  IM    
Department of Anesthesiology, University Hospitals of Cleveland, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, LKSD 2500, Cleveland, OH 44106-5007, USA.
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MeSH Terms
Anesthesia, General / methods*
Dyspnea / etiology
Hoarseness / etiology
Laryngeal Neoplasms / surgery*
Laser Therapy / methods*
Papilloma / surgery*
Pregnancy Complications, Neoplastic / surgery*
Treatment Outcome

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