Resumo
JUSTIFICATIVA E OBJETIVOS: A embolia venosa por CO2 durante cirurgias laparoscópicas é uma complicação rara, porém fatal na maioria dos casos. O objetivo deste relato é descrever um caso não fatal de embolia venosa por CO2 durante cirurgia laparoscópica. RELATO DO CASO: Paciente hipertensa foi submetida à anestesia geral para laparoscopia para exploração de colédoco. Após 150 minutos de pneumoperitôneo, a paciente evoluiu com taquicardia e hipotensão refratária ao uso de vasopressor. A gasometria arterial revelou grande diferença entre a pCO2 e a P ET CO2. Frente à hipótese de embolia gasosa, foi desinsuflado o pneumoperitôneo, e a cirurgia terminada pela técnica convencional. A paciente evoluiu com melhora do quadro hemodinâmico, sendo extubada ao término da cirurgia e encaminhada para sala de recuperação pós-anestésica (SRPA). CONCLUSÕES: O diagnóstico precoce e o tratamento imediato foram fundamentais na boa evolução do caso descrito.
Palavras-chave
CIRURGIA, Abdominal, COMPLICAÇÕES
Abstract
BACKGROUND AND OBJECTIVES: Carbon dioxide gas embolism is an uncommon but potentially lethal complication of laparoscopic surgery. Our report aimed at describing a case of pulmonary carbon dioxide embolism with favorable evolution. CASE REPORT: Hypertensive patient was submitted to laparoscopic surgery under general anesthesia due to cholelithiasis. After 150 minutes of pneumoperitoneum, patient developed tachycardia with severe hemodynamic deterioration, despite the use of vasopressor drugs. Arterial blood-gas revealed major difference between PaCO2 and P ET CO2. Carbon dioxide embolism was suspected and pneumoperitoneum was immediately deflated. Surgery was converted to a conventional technique. Patient has evolved with hemodynamic improvement and was extubated at surgery completion, being referred to post-anesthetic care unit (PACU). CONCLUSIONS: Early diagnosis and immediate treatment resulted in positive outcome in this case.
Keywords
COMPLICATIONS, SURGERY, Abdominal
References
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