Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942002000200012
Brazilian Journal of Anesthesiology
Clinical Information

Embolia pulmonar na sala de cirurgia: relato de caso

Pulmonary embolism in the operating room: case report

Karina Bernardi Pimenta; Beatriz do Céu Nunes

http://dx.doi.org/10.1590/S0034-70942002000200012 Braz J Anesthesiol, vol.52, n2, p.236-241, 2002
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Resumo

JUSTIFICATIVA E OBJETIVOS: Embolia pulmonar é uma complicação freqüente no período pós-operatório. O objetivo deste relato é apresentar um caso de embolia pulmonar ocorrida na sala de operação e chamar a atenção para a importância da profilaxia de trombose venosa em pacientes cirúrgicos. RELATO DO CASO: Trata-se de um paciente do sexo masculino, 55 anos e 83 kg com diagnóstico de câncer de próstata, submetido a prostatectomia supra-púbica sob anestesia geral. Ao final da cirurgia, o paciente já extubado e logo após sua passagem para a maca de transporte apresentou instabilidade hemodinâmica e diminuição da SpO2 para 80%. Foi reintubado e encaminhado para a UTI. A tomografia computadorizada mostrou imagens com aspecto de embolia pulmonar. O paciente evoluiu para óbito no 5º dia de pós-operatório. CONCLUSÕES: O elevado índice de suspeita não é suficiente para firmar o diagnóstico pois a embolia pulmonar é uma doença silenciosa e a rotina de investigação não possui elevada sensibilidade. A profilaxia precoce e adequada é a melhor estratégia.

Palavras-chave

CIRURGIA, Urológica, COMPLICAÇÕES

Abstract

BACKGROUND AND OBJECTIVES: Pulmonary embolism is a common postoperative complication. This report aimed at presenting a case of pulmonary embolism in the operating room and at calling the attention to the importance of venous thrombosis prophylaxis in surgical patients. CASE REPORT: The authors describe a case of a male patient, 55 years of age and 83 kg submitted to radical prostatectomy for prostate cancer. At the end of the surgery and already extubated, patient presented hemodynamic instability and a decrease in SpO2 to 80%. Patient was re-intubated and sent to the ICU. CT images suggested pulmonary embolism. Patient died in the 5th postoperative day. CONCLUSIONS: A high suspicion rate is not enough to establish a diagnosis because pulmonary embolism is a silent disease and its investigation routine is not highly sensitive. Early prophylaxis is the best strategy.

Keywords

COMPLICATIONS, SURGERY, Urologic

References

Knobel E, Baruzzi AC. Condutas no Paciente Grave. 1999:197-210.

Nakano T, Goldhaber SZ. Pulmonary Embolism. 1999:1-14.

Levitan N, Dowlati A, Remick SC. Rates of initial and recurrent thromboembolic disease among patients with malignancy versus those without malignancy. Medicine. 1999;78:285-291.

Goldhaber ZS. Pulmonary Embolism. Braunwald - Heart Disease a Textbook of Cardiovascular Medicine. 2001;52:1886-1907.

Whalley GD, Berrigan JM. Anesthesia for radical prostatectomy, cystectomy, nephrectomy, pheochromocytoma, and, laparoscopic procedures. Anesthesiology Clinics of North America. 2000;18:889-917.

De Wet CJ, Pearl RG. Perioperative use of anticoagulants and thrombolytics. Anesthesiology Clinics of North America. 1999;17:895-917.

Krivec B, Voga G, Zuran I. Diagnosis and treatment of shock due to massive pulmonary embolism. Chest. 1997;112:1310-1316.

Clagett GP, Anderson FAJ, Geerts W. Prevention of venous thromboembolism. Chest. 1998;114:531S-560S.

Neuraxial Anesthesia and Anticoagulation, Consensus Statements. . :2-3.

Horlocker TT, Heit JA. Low molecular weight heparin: biochemisty, pharmacology, perioperative prophylaxis regimens and Guidelines for Regional Anesthetic Management. Anesth Analg. 1997;85:874-885.

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