ABSTRACT
Background@#Hysteroscopic surgery has been used in various gynecological fields. However, massive fluid overload can occur as a complication due to persistent infusion of media for uterine cavity distension. We present the case of a woman who developed cardiomyopathy with pulmonary edema and epistaxis during hysteroscopic surgery.Case: A 76-year-old female underwent hysteroscopic septectomy. She manifested abrupt, active nasal bleeding and regurgitation in the intravenous line. Heart rate, SpO2, and PETCO2 decreased from 55 beats/min to 29 beats/min, from 100% to 56%, and from 31 mmHg to 9 mmHg, respectively. After the operation, brain CT showed bilateral prominent superior ophthalmic vein dilation. Echocardiography showed left ventricle apical ballooning and global hypokinesia. The patient recovered after two days of conservative management, with no sequelae. @*Conclusions@#Although hysteroscopic surgery is a simple procedure, careful monitoring is necessary to prevent complications from absorption of fluid distending media during the procedure.
ABSTRACT
Abdominal compartment syndrome can produce a critical situation if not diagnosed early and managed properly. We report a case of abdominal compartment syndrome that was caused by massive irrigation of surgical fluid during endoscopic lumbar diskectomy at the L4–L5 level. There was a sudden increase in peak inspiratory pressure during the operation, and the patient's tidal volume and blood pressure decreased. When the patient's position was changed from prone to supine, abdominal distension and cyanosis of both lower extremities were discovered. Ultrasonic findings showed fluid collection in both the chest and intra-abdominal cavity. Thoracentesis and abdominal decompression surgery were performed, and the patient's overall state improved. We concluded that irrigation fluid used during the endoscopic operation leaked into the retroperitoneal space and caused abdominal compartment syndrome.
Subject(s)
Blood Pressure , Cyanosis , Diskectomy , Endoscopy , Intra-Abdominal Hypertension , Lower Body Negative Pressure , Lower Extremity , Retroperitoneal Space , Thoracentesis , Thorax , Tidal Volume , UltrasonicsABSTRACT
BACKGROUND: Use of GlideScope® laryngoscopes and lightwands for tracheal intubation does not require much force. Theoretically, less stimulation can reduce hemodynamic changes during intubation. We investigated the hemodynamic response to tracheal intubation using different laryngoscope types during remifentanil infusion. METHODS: Sixty American Society of Anesthesiologists class I-II patients were compared in terms of tracheal intubation time, hemodynamic changes, and postoperative pharyngeal complications when using a GlideScope®, lightwand, or Macintosh laryngoscope. Propofol and rocuronium were injected and remifentanil was infused for three minutes. Blood pressure and heart rate were measured before and 1, 3, and 5 minutes after tracheal intubation. Patients were assessed for postoperative oral and tracheal bleeding as well as hoarseness, dysphagia, and sore throat. RESULTS: Intubation time was prolonged in the GlideScope® group. All three groups showed a significant decrease in systolic and diastolic blood pressure 1, 3, and 5 minutesafter tracheal intubation. Heart rates increased significantly in all three groups immediately after intubation as well as 1 minute later in the GlideScope® group. However, there were no differences in blood pressure, heart rate, or the occurrence of hoarseness, dysphagia, and sore throat among the three groups. CONCLUSIONS: No differences in hemodynamic change were found among the three different techniques.
Subject(s)
Humans , Blood Pressure , Deglutition Disorders , Heart Rate , Hemodynamics , Hemorrhage , Hoarseness , Intubation , Laryngoscopes , Pharyngitis , PropofolABSTRACT
BACKGROUND: Use of GlideScope® laryngoscopes and lightwands for tracheal intubation does not require much force. Theoretically, less stimulation can reduce hemodynamic changes during intubation. We investigated the hemodynamic response to tracheal intubation using different laryngoscope types during remifentanil infusion. METHODS: Sixty American Society of Anesthesiologists class I-II patients were compared in terms of tracheal intubation time, hemodynamic changes, and postoperative pharyngeal complications when using a GlideScope®, lightwand, or Macintosh laryngoscope. Propofol and rocuronium were injected and remifentanil was infused for three minutes. Blood pressure and heart rate were measured before and 1, 3, and 5 minutes after tracheal intubation. Patients were assessed for postoperative oral and tracheal bleeding as well as hoarseness, dysphagia, and sore throat. RESULTS: Intubation time was prolonged in the GlideScope® group. All three groups showed a significant decrease in systolic and diastolic blood pressure 1, 3, and 5 minutesafter tracheal intubation. Heart rates increased significantly in all three groups immediately after intubation as well as 1 minute later in the GlideScope® group. However, there were no differences in blood pressure, heart rate, or the occurrence of hoarseness, dysphagia, and sore throat among the three groups. CONCLUSIONS: No differences in hemodynamic change were found among the three different techniques.