Läkartidningen
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Case Reports
[Postoperative laryngospasm may induce pulmonary edema. An unusual or overlooked complication?].
Young and healthy patients in whom laryngospasm secondary to postoperative extubation is encountered run a risk of developing pulmonary edema. The mechanism behind the edema is thought to be a strongly negative intrathoracic pressure generated by the patient's forced inspiration against a closed glottis. A net flow of fluid occurs to the interstitial space and further to the alveoli. ⋯ The condition is potentially life-threatening, but usually responds favourably to positive pressure ventilation and diuretics. In anaesthesia and intensive care, it is important to be aware of the complication in order to be ready for adequate therapy when needed. We present three cases from the Central Hospital in Växjö, where pulmonary edema occurred directly following postoperative extubation.
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Pain is a major public health problem. The management of orofacial pain may be a difficult challenge to the medical and dental professions. Ideally, severe cases of this type of pain should be treated by a team drawn from several disciplines such as neurology, otolaryngology, dentistry and psychiatry. ⋯ When pus is present, drainage affords excellent pain relief. Acute pericoronitis involving mandibular third molars responds to irrigation, removal of maxillary third molar trauma, and--in cases of serious infection--antimicrobial therapy. Early recognition of a case of chronic pain improves the chances of successful management, and avoids frustration and disillusion both to patient and doctor.