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Pneumothorax in association with spontaneous ventilation general anaesthesia—an unusual cause of hypoxaemia

Department of Anaesthesia and Intensive Care, The Northern Hospital, Melbourne, Victoria, Australia


A 43-year-old ASA PS II male patient developed a pneumothorax while breathing spontaneously through a supraglottic airway device during a general anaesthetic. Unexplained hypoxaemia occurred after an episode of coughing. Clinical examination appeared to be normal apart from the persistent oxygen desaturation. A pneumothorax was diagnosed in the post anaesthesia care unit by chest X-ray. The pneumothorax responded to conventional management and the patient made an uneventful recovery. We recommend a high index of suspicion in any patient who coughs and later has unexplained hypoxaemia during general anaesthesia, even if a supraglottic airway device has been inserted.

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