Re-insufflation after deflation of a pneumoperitoneum is a risk factor for CO2 embolism during laparoscopic prostatectomy: A case report / 대한마취과학회지
Korean Journal of Anesthesiology
;
: S201-S206, 2010.
Article
in English
| WPRIM
| ID: wpr-202668
ABSTRACT
Although symptomatic carbon dioxide (CO2) embolism is rare, it recognized as a potentially fatal complication of laparoscopic surgery. Sudden hemodynamic instability could be a CO2 embolism especially during insufflation. A 65-year-old man received laparoscopic prostatectomy for 5 hours under CO2 pneumoperitoneum without any problem. After resection of prostate, it was stopped following deflation. Thirty minutes later, peumoperitoneum was re-induced to continue the operation. Shortly after re-insufflation, the patient revealed hemodynamic instability suggested a CO2 embolism; severe hypotension, tachyarrythmia, hypoxemia, increased CVP, and changed end-tidal CO2. Gas insufflation was stopped. He was managed with Durant's position, fluid and cardiotonics for 20 minutes. The residual was completed by open laparotomy. Re-insufflation, inducing gas entry through the injured vessels, might be a risk factor for CO2 embolism in this case. The risk to the patient may be minimized by the surgical team's awareness of CO2 embolism and continuous intra-operative monitoring of end-tidal CO2.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pneumoperitoneum
/
Prostate
/
Prostatectomy
/
Carbon Dioxide
/
Insufflation
/
Cardiotonic Agents
/
Risk Factors
/
Laparoscopy
/
Embolism
/
Hemodynamics
Type of study:
Etiology study
/
Risk factors
Limits:
Aged
/
Humans
Language:
English
Journal:
Korean Journal of Anesthesiology
Year:
2010
Type:
Article
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