Enfisema subcutâneo causado por sonda nasofaríngea para administração de oxigênio suplementar: relato de caso

Juliano Rodrigues Gasparini; Luciano Costa Ferreira; Victor Hugo Mariath Rangel

doi:10.1590/S0034-70942010000500013

Informação Clínica

Enfisema subcutâneo causado por sonda nasofaríngea para administração de oxigênio suplementar: relato de caso

Subcutaneous emphysema induced by supplementary oxygen delivery nasopharyngeal cannula: case report

Juliano Rodrigues Gasparini; Luciano Costa Ferreira; Victor Hugo Mariath Rangel

http://dx.doi.org/10.1590/S0034-70942010000500013 Braz J Anesthesiol, vol.60, n5, p.558-562, 2010

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JUSTIFICATIVA E OBJETIVOS: A ocorrência de enfisema subcutâneo atingindo face, pescoço e tórax está bem documentada em casos de procedimentos odontológicos, cirurgia de cabeça e/ou pescoço e trauma craniofacial. Sua ocorrência sem lesão reconhecida das mucosas é rara. Este relato descreve um caso clínico em que o enfisema ocorreu sem uma lesão óbvia. RELATO DO CASO: Paciente do sexo masculino, hígido, submetido a anestesias peridural e local associadas à sedação, para a realização de lipoaspiração de abdome e região submentoniana. Procedimento sem intercorrências até posicionar uma sonda nasofaríngea para administrar oxigênio suplementar. Descreve também uma abordagem alternativa para sua resolução. CONCLUSÕES: Embora raro, o enfisema subcutâneo pode ter graves repercussões. A drenagem linfática manual pode ser uma opção para o tratamento da complicação estética

Palavras-chave

COMPLICAÇÕES, CIRURGIA, Plástica

Abstract

BACKGROUND AND OBJECTIVES: The development of subcutaneous emphysema involving face, neck, and thorax has been well-documented in cases of odontologic procedures, head and/or neck surgery, and craniofacial trauma. Its development without known damage to the mucosa is rare. This report describes the case of a patient who developed emphysema without an obvious lesion. CASE REPORT: This is a male patient, healthy, undergoing epidural blockade and local anesthesia associated with sedation for lipoaspiration of the abdomen and submentonian region. Intercurrences were not observed during the procedure until a nasopharyngeal cannula was placed for oxygen administration. We also describe an alternative approach for its resolution. CONCLUSIONS: Although rare, subcutaneous emphysema can have serious repercussions. Manual lymphatic drainage can be an option for the treatment of this aesthetical complication

Keywords

COMPLICATONS, SURGERY, Plastic

Referências

Horowitz I, Hirshberg A, Freedman A. Pneumomediastinum and emphysema following surgical extraction of mandibular third molars: three case reports. Oral Surg. 1987;63:25-28.

Torres-Melero J, Arias-Díaz J, Balibrea JL. Pneumomediastinum secondary to use of high speed turbine drill during a dental extraction. Thorax. 1996;51:339-340.

Schakelford D, Casani JA. Diffuse subcutaneous emphysema, pneumomediastinum and pneumothorax after dental extraction. Ann Emerg Med. 1993;22:248-250.

Samuels TL. Rare complications of surgical emphysema and pneumomediastinum occurring post dental extraction. Postgrad Med J. 2009;85.

Sandford TJ, Shapiro HM, Gallick MN. Pericardial and subcutaneous air after maxillary surgery. Anesth Analg. 1987;66:277-279.

Celebioµlu S, Keser A, Ortak T. An unusual complication of rhinoplasty: subcutaneous emphysema. Br J Plast Surg. 1998;51:266-267.

Hata T, Hosoda M. Cervicofacial subcutaneous emphysema after oral laser surgery. Br J Oral Maxillofac Surg. 2001;39:161-162.

Almong S, Mayron Y, Weiss J. Pneumomediastinum following blow out fracture of the medial orbital wall: a case report. Ophthal Plast Reconstr Surg. 1993;9:289-291.

Kourtidou-Papadeli , Paspatis A, Mohler S. Pneumomediastinum during flight secondary to facial fractures: a case report. Aviat Space Environ Med. 1996;67:1201-1203.

Newman P, Radford P, Eppel BJ. Supplementary oxygen causing surgical emphysema. Anaesthesia. 1992;47:275-276.

Merino-Angulo J, Perez de Diego I, Casas JM. Subcutaneous emphysema as a complication of oxygen therapy using nasal cannulas. N Engl J Med. 1987;316.

McHugh T. Pneumomediastinum following penetrating oral trauma. Pediatr Emerg Care. 1997;13:211-213.

Bremner WG, Kumar CM. Delayed surgical emphysema, pneumomediastinum and bilateral pneumothoraces after postoperative vomiting. Br J Anaesth. 1993;71:296-297.

Miller WE, Spiekerman RE, Hepper NG. Pneumomediastinum resulting from performing Valsalva maneuvers during marihuana smoking. Chest. 1972;62:233-234.

Moseley AL, Carati CJ, Piller NB. A systematic review of common conservative therapies for arm lymphoedema secondary to breast cancer treatment. Ann Oncol. 2007;18:639-646.

Bordin NA, Guerreiro Godoy M, Pereira de Godoy JM. Mechanical lymphatic drainage in the treatment of arm lymphedema. Indian J Cancer. 2009;46:337-339.

Koul R, Dufan T, Russell C. Efficacy of complete decongestive therapy and manual lymphatic drainage on treatment-related lymphedema in breast cancer. Int J Radiat Oncol Biol Phys. 2007;67:841-846.

Enfisema subcutâneo causado por sonda nasofaríngea para administração de oxigênio suplementar: relato de caso

Subcutaneous emphysema induced by supplementary oxygen delivery nasopharyngeal cannula: case report

Juliano Rodrigues Gasparini; Luciano Costa Ferreira; Victor Hugo Mariath Rangel

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