Re-insufflation after deflation of a pneumoperitoneum is a risk factor for CO2 embolism during laparoscopic prostatectomy -A case report-

Title
Re-insufflation after deflation of a pneumoperitoneum is a risk factor for CO2 embolism during laparoscopic prostatectomy -A case report-
Author(s)
송선옥성채림[성채림]최은지[최은지]
Keywords
Cardiovascular collapse; CO2 embolism; Laparoscopic prostatectomy; Re-insufflation.
Issue Date
201012
Publisher
대한마취통증의학회
Citation
Korean Journal of Anesthesiology, v.59, pp.201 - 206
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.
URI
http://hdl.handle.net/YU.REPOSITORY/23116
ISSN
2005-6419
Appears in Collections:
의과대학 > 마취통증의학교실 > Articles
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