Acute Pulmonary Oedema: A Post-Operative Complication Due to Neostigmine and Post Obstructive Pulmonary Oedema in a Case of Tonsillectomy

Acute pulmonary oedema has been described in relation to perioperative period. The aetiology may be multifactorial and its management poses a challenge to the anaesthesiologist. Its occurrence in a normal healthy person with no other medical history makes the diagnosis difficult. The causes of pulmonary oedema are cardiac failure, fluid overload, airway obstruction, acid aspiration, gas embolism, anaesthetic drugs, sepsis, anaphylactic reaction and reaction to blood & blood products. Early detection, prompt management by an anaesthesiologist will help to prevent further postoperative complications. We report a case of 9-year-old male child, posted for tonsillectomy under general anaesthesia, who developed acute pulmonary oedema following extubation after reversal with neostigmine and how we managed it successfully.