Pneumothorax during Retroperitoneal Laparoscopic Nephrectomy: A case report / 대한마취과학회지

Recently, laparoscopic techniques are being increasingly used for retroperitoneal surgery. These procedures are considered relatively safe and non-invasive, however, there exists a small but important risk of developing complications related to insufflation with carbon dioxide (CO2). A 51-year-old female patient was admitted for retroperitoneal laparoscopic nephrectomy under general anesthesia. About 60 minutes after carbon dioxide pneumoperitoneum, the patient's oxygen saturation decreased. A chest x-ray was taken in the operating room, which showed pneumothorax in the right lung. We concluded that anesthesiologists should be aware of the occurrence of pneumothorax during the retroperitoneal laparoscopic procedure careful monitoring and appropriate management are needed.

The Effect of Pneumoperitoneum on Thoracoabdominal Aortic Blood Flow in Laparoscopic Cholecystectomy / 대한마취과학회지

BACKGROUND:We performed this study to determine the influence of the administration of pneumoperitoneum on the blood flow of the thoracoabdominal aorta during laparoscopic cholecystectomy (LC). METHODS: Ten patients for LC were enrolled in this study. Anesthesia was performed with propofol, fentanyl and rocuronium. Pneumoperitoneum was made by CO2 gas intraperitoneal instillation at an intraperitoneal pressure of 10-12 mmHg. Peak velocity of blood flow in the systolic phase (PV), mean acceleration of blood flow from the start of systole (MA) and systolic flow time corrected for heart rate (FTc), measured by esophageal doppler monitoring (EDM), and heart rate (HR) and mean brachial BP (MBP) were measured 1, 5 and 10 min after the institution of pneumoperitoneum, (T1, T5 and T10) and compared with those before the institution of pnuemoperotoneum (T0). LC was started after recording all measurements and a position change to the reverse-Trendelenberg position. RESULTS: PV, MA, FTc and HR showed no significant change throughout this study, but MBP at T5 and T10 (110.1 +/- 18.5 mmHg and 107.8 +/- 10.4 mmHg) were significantly higher than at T0 (84.9 +/- 12.9 mmHg) (P = 0.002 and 0.005 respectively). CONCLUSIONS: The administration of pneumoperitoneum neither changed nor interferenced with abdominal aortic blood flow.