DOI: https://doi.org/10.36347/sjmcr.2025.v13i11.015

Pages: 2731-2733

Performing the cuff leak test (CLT) prior to extubation to detect postoperative laryngealn stridor was a common practice among anesthesiologists prepandemically. Its diagnostic accuracy has been analyzed in several previous studies. Due to its limitations and the risk of aerosolization of the virus in the operating room, CLT is carried out less than before for fear of contamination in the era of COVID-19. We have encountered a patient who presented significant post extubation stridor and shortness of breath with desaturation reaching 90% following laparoscopic appendectomy. After exclusion of other etiologies, the respiratory distress was attributed to post extubation laryngeal edema. In addition to oxygen therapy provided by a nonrebreather mask, the patient was given methylprednisolone and was nebulized with epinephrine which allowed a rapid clinical improvement. The patient was weaned off oxygen after 2 hours and left the post anesthesia care unit after 12 hours. This scenario occurred because a CLT was not performed prior to extubation.