Abstract
The use of laparoscopic surgery has grown considerably, and the occurrence of some accidents, albeit rare, is now reported. Among them, gas embolism can induce a bad postoperative outcome. We report seven cases of carbon dioxide embolism (CO2) during laparoscopic surgery. In the seven cases gas embolism occurred during insufflation or a few minutes later. All the patients had a previous abdominal or pelvic surgical history. Five patients presented cardiac bradycardia or arrhythmia. Cardiovascular collapse or cyanosis was the first manifestation in three cases. Sudden bilateral mydriasis was the earliest neurologic sign, present in five cases. Finally, the gas embolism complication was lethal in two cases. In summary, this study strongly stresses the need for precise rules of prevention of gas embolism, and close monitoring of cardiac rhythm during insufflation of carbon dioxide. The patients who had previous surgery should be considered as a risk population.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Adornato DC, Gildenberg PL, Ferrario CM, Smart J, Frost EAM (1978) Pathophysiology of intravenous air embolism in dogs. Anesthesiology 49: 120–127
Alvaran SB, Toung JK, Graff TE, Benson SW (1978) Venous air embolism: comparative merits of external cardiac massage, intracardiac aspiration, and left lateral decubitus position. Anesth Analg 57: 166–170
Brantley JC, Riley PM (1988) Cardiovascular collapse during laparoscopy: a report of two cases. Am J Obstet Gynecol 159: 735–737
Diakun TA (1991) Carbon dioxide embolism: successful resuscitation with cardiopulmonary bypass. Anesthesiology 74: 1151–1153
Furuya H, Suzuki T, Okumura F, Kishi Y, Uefuji T (1983) Detection of air embolism by transesophageal echocardiography. Anesthesiology 58: 124–129
Grim PS, Gottlieb LJ, Boddie A, Batson E (1990) Hyperbaric oxygen therapy. J Am Med Assoc 263: 2216–2220
Holohan TV (1991) Laparoscopic cholecystectomy. Lancet 338: 801–803
Hynes SR, Marshall RL (1992) Venous gas embolism during gynaecological laparoscopy. Can J Anaesth 39: 748–749
Lee CM (1975) Acute hypotension during laparoscopy: a case report. Anesth Analg 54: 142–143
Mullet CE, Viale JP, Sagnard PE, et al. (1993) Pulmonary CO2 elimination during surgical procedures using intra or extraperitoneal CO2 insufflation. Anesth Analg 76: 622–626
Root B, Levy MN, Pollack S, Lubert M, Pathak K (1978) Gas embolism death after laparoscopy delayed by “trapping” in portal circulation. Anesth Analg 57: 232–237
Seed RF, Shakespeare TF, Muldoon MJ (1970) Carbon dioxide homeostasis during anesthesia for laparoscopy. Anaesthesia 25: 223–231
Shulman D, Aronson HB (1984) Capnography in the early diagnosis of carbon dioxide embolism during laparoscopy. Can Anaesth Soc J 31: 455–459
Wadhwa RK, McKenzie R, Wadhwa SR, Katz DL, Byers JF (1978) Gas embolism during laparoscopy. Anesthesiology 48: 74–76
Yacoub OF, Cardona I, Coveler LA, Dodson MG (1982) Carbon dioxide embolism during laparoscopy. Anesthesiology 57: 533–535
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Cottin, V., Delafosse, B. & Viale, J.P. Gas embolism during laparoscopy. Surg Endosc 10, 166–169 (1996). https://doi.org/10.1007/BF00188365
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00188365