Successful Resuscitation After Carbon Dioxide Embolism During Laparoscopic Cholecystectomy

Abstract

Laparoscopic surgery is preferred since it shortens stay in hospital, lessens postoperative pain and complications, and because of the cosmetic advantages. Laparoscopic cholecystectomy surgery was planned for a 27 year old female patient, who was 110 kg and 167 cm tall. During the preoperative physical examination nothing was determined other than the morbid obesity (BMI:39). CO2 insuflation was started by using a Veress needle under the belly. When desaturation and frequent ventricular early fibrillation developed, CO2 insuflation was immediately stopped. Since the arrhythmias of the patient continued, 100 mg of lidocaine i.v. was applied and 100% of O2 was started. The table was positioned as trendelenbrug and it was turned to left. Bradycardia and cardiac arrest developed in the patient whose SpO2 was measured at 65% when desaturation increased. Immediately 1 mg of atropin and 1 mg of adrenalin i.v. was given and cardiopulmonary resuscitation and external cardiac massage was applied. After giving totally 4 mg of adrenalin in a number of doses, sinus tachycardia developed in the approximately 20th minute of the resuscitation. The patient was extubated and taken to intensive care nearly 60 minutes after the induction. In the abdominal USG done during the postoperative early phase, no free liquid was determined in the abdomen. Postoperative blood counts were stabilized. The patient was discharged the next day, and 3 months later, a nonproblematic laparoscopic cholecystectomy surgery was done.