Korean J Anesthesiol.  2005 Nov;49(5):712-715. 10.4097/kjae.2005.49.5.712.

Cardiac Arrest after Gas Insufflation for Laparoscopic Surgery: Two case reports

• Cho EJ
• Min TK

• KMID: 1936834
• DOI: http://doi.org/10.4097/kjae.2005.49.5.712

Abstract

Laparoscopic surgery is a frequently used technique in surgery. But artificial pneumoperitoneum with CO2 causes cardiovascular complication. We experienced two cases of cardiac arrests after gas insufflation. In first case, end tidal CO2 concentration increased rapidly and then immediately cardiac arrest occurred. We performed cardiac resuscitation with epinephrine and cardiac compression and result in good recovery. A rapid rise in end tidal concentration is suggested as a useful early sign of CO2 embolism. In second case, cardiac arrest occurred after gas insufflation, too. We used atropine and ephedrine but severe bradycardia and hypotension was not recovered. After removal of CO2, heart rate and blood pressure restored. We found that flow rate of CO2 was 50 L/min. The operation was started again, we used flow rate of CO2 at 1 L/min. The operation was successful uneventfully. Slow insufflation combined with close monitoring is important to prevent cardiovascular collapse during laparoscopic surgery.

Keyword

carbon dioxide; cardiovascular collapse; laparoscopic surgery

MeSH Terms

Atropine
Blood Pressure
Bradycardia
Carbon Dioxide
Embolism
Ephedrine
Epinephrine
Heart Arrest*
Heart Rate
Hypotension
Insufflation*
Laparoscopy*
Pneumoperitoneum, Artificial
Resuscitation
Atropine
Carbon Dioxide
Ephedrine
Epinephrine