Biomaterial Database

Acute Intraoperative Tympanic Membrane Rupture in Patient Anesthetized With Desflurane Without Nitrous Oxide: A Case Report. 2024

Dylan J Cincotta, and Jacob B Brandenburg

From the University of Utah Department of Anesthesiology, Salt Lake City, UT.

We report a case of acute intraoperative tympanic membrane (TM) rupture in a patient anesthetized with desflurane without N2O. The patient was undergoing endoscopic retrograde cholangiopancreatography (ERCP) to treat ascending cholangitis. TM rupture is known to occur with N2O but has not been reported in the literature with the use of inhaled volatile anesthetics without N2O. We suspect that several factors contributed to this complication, including prone positioning, a remote history of ear trauma, and the selection of desflurane as the maintenance anesthetic as opposed to a vapor with a higher blood-gas partition coefficient.

UI	MeSH Term	Description	Entries
D007530	Isoflurane	A stable, non-explosive inhalation anesthetic, relatively free from significant side effects.
D009609	Nitrous Oxide	Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream.	Laughing Gas,Nitrogen Protoxide,Gas, Laughing,Oxide, Nitrous
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077335	Desflurane	A fluorinated ether that is used as a volatile anesthetic for maintenance of general anesthesia.	1,2,2,2-Tetrafluoroethyl difluoromethyl ether,I 653,I-653,I653,Suprane
D000769	Anesthesia, Inhalation	Anesthesia caused by the breathing of anesthetic gases or vapors or by insufflating anesthetic gases or vapors into the respiratory tract.	Insufflation Anesthesia,Anesthesia, Insufflation,Inhalation Anesthesia
D018058	Tympanic Membrane Perforation	A temporary or persistent opening in the eardrum (TYMPANIC MEMBRANE). Clinical signs depend on the size, location, and associated pathological condition.	Eardrum Perforation,Tympanic Membrane Rupture,Membrane Perforation, Tympanic,Membrane Rupture, Tympanic,Perforation, Eardrum,Rupture, Tympanic Membrane
D018685	Anesthetics, Inhalation	Gases or volatile liquids that vary in the rate at which they induce anesthesia; potency; the degree of circulation, respiratory, or neuromuscular depression they produce; and analgesic effects. Inhalation anesthetics have advantages over intravenous agents in that the depth of anesthesia can be changed rapidly by altering the inhaled concentration. Because of their rapid elimination, any postoperative respiratory depression is of relatively short duration. (From AMA Drug Evaluations Annual, 1994, p173)	Inhalation Anesthetic,Inhalation Anesthetics,Anesthetic Gases,Anesthetic, Inhalation,Gases, Anesthetic