Negative pressure pulmonary edema following septoplasty surgery triggering acute subendocardial myocardial infarction.

Negative pressure pulmonary edema (NPPE) is defined as fluid transudation into the pulmonary interstitium which occurs as a result of elevated negative intrathoracic pressure caused by the upper respiratory tract obstruction and strong inspiratory effort. NPPE is usually seen during emergence from general anesthesia in the early post-operative period especially after upper respiratory tract surgery. We present a case of a 37-year-old male patient who underwent septoplasty operation and developed NPPE which could not diagnosed and progressed to acute subendocardial myocardial infarction.

Analgesic effects of interpleural bupivacaine with fentanyl for post-thoracotomy pain.

Objective: The analgesic effect of bupivacaine/fentanyl with epinephrine given interpleurally after thoracotomy was investigated in a randomized placebo and intravenous controlled study.

Design: Prospective clinical study.

Setting: University teaching hospital.