title: Uvular edema secondary to snoring under deep sedation.
abstract: A 57-year-old male with a documented history of obstructive sleep apnea with loud snoring received deep intravenous sedation with midazolam, fentanyl, ketamine, and propofol infusion and a left interscalene brachial plexus nerve block for a left biceps tendon repair. Loud snoring during the case was noted. On the second postoperative day, he was observed to have significant uvular edema. After due consideration of the various elements in the differential diagnosis, it was concluded that negative pressure trauma from deep snoring during the sedation was the most likely etiology.
authors.affiliation: Department of Surgery, Wright State University, Dayton, Ohio, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Miller
authors.forename: Mark A
authors.initials: MA
authors.lastname: Gerhardt
mesh_terms: D000778:Anesthetics, Dissociative / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001132:Arm; D001917:Brachial Plexus; D004487:Edema / Q000209:etiology*; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007649:Ketamine / Q000008:administration & dosage; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D009407:Nerve Block; D011183:Postoperative Complications; D015742:Propofol / Q000008:administration & dosage; D020181:Sleep Apnea, Obstructive / Q000150:complications; D012913:Snoring / Q000150:complications*; D013710:Tendons / Q000601:surgery; D014609:Uvula / Q000473:pathology*
chemical_list: D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D007649:Ketamine; D008874:Midazolam; D005283:Fentanyl; D015742:Propofol