The nasocardiac reflex

inflation pressures during intermittent positive pressure ventilation could produce barotrauma and bilateral pleural air leak, but in this situation cardiovascular instability from the resulting tension pneumothorax would be expected and this did not occur.since the patient's condition improved rapidly with the treatment described.This case emphasises that a major complication may follow an apparently straightforward operation in the area of the trachea.Vigilance is required in order that such a complication is recognised and treated promptly.