Airway management of tetanus after the Haitian earthquake: New aspects of old observations

Paul G. Firth*, James B. Solomon, Laura L. Roberts, Todd D. Gleeson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Two men developed severe tetanus after the 2010 Haitian earthquake. They were admitted to the United States Naval Ship Comfort, a hospital ship sent to provide humanitarian relief. Severe masseter and intercostal muscle spasm impaired airway access and ventilation. Propofol and sevoflurane relieved the tetany, allowing airway control and ventilation without intubation or neuromuscular blocking drugs during wound debridement. Presynaptic impairment of inhibitory neurotransmitter release by tetanospasmin toxin is countered by enhancement of spinal cord postsynaptic inhibitory receptor activity by general anesthetics. Avoidance of tracheal intubation and mechanical ventilation during anesthesia may be desirable in the settings of limited resources in which tetanus usually presents.

Original languageEnglish
Pages (from-to)545-547
Number of pages3
JournalAnesthesia and Analgesia
Volume113
Issue number3
DOIs
StatePublished - Sep 2011
Externally publishedYes

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