Prevention of air embolism during hysteroscopy

  • admin admin
  • Rahil Singh
  • Rajeev Sharma
  • Aruna Jain
  • Sunil Sinha
  • Tanvir Samra
Keywords: Venous air embolism, Hysteroscopy

Abstract

Citation: Singh R, Sharma R, Jain A, Sinha S, Samra T. Prevention of air embolism during hysteroscopy (Correspondence). Anaesth Pain & Intensive Care 2014;18(4):469-70

Air embolism is a potentially catastrophic complication of operative hysteroscopy. Its incidence varies from 10-50% depending on the detection method used but prevalence of subclinical embolism may be as high as 100%.1,2 We recently witnessed this complication in two patients and we briefly describe the preventive and therapeutic measures needed in such cases.

Twenty eight year old, ASA PS 1 female was scheduled for hysteroscopic guided Copper–T (Cu-T) removal. She underwent the same procedure previously, which was unsuccessful as only one limb of the Cu-T could be removed. Routine monitors were attached and anaesthesia was induced with IV propofol and fentanyl followed by insertion of No. 3 Proseal™ laryngeal mask airway. Anaesthesia was maintained with spontaneous breathing of oxygen (O2), nitrous oxide (N2O) and sevoflurane. The patient was placed in lithotomy position with 20⁰ Trendelenburg position. Hysteroscopy was performed using normal saline pressurized by pressure infuser on 3 lit non-collapsible bottle. Cu-T was firmly embedded in the myometrium and removed after vigorous extraction following which the patient developed pulseless electrical activity (PEA), with no recordable EtCOand blood pressure. No heart sounds were heard but ECG showed sinus rhythm with heart rate of 90 bpm. Patient was immediately turned supine and administered 100% Oafter trachea was intubated. Cardiopulmonary resuscitation was done for 45 min but patient could not be revived.

Published
05-17-2019
How to Cite
admin, admin, Singh, R., Sharma, R., Jain, A., Sinha, S., & Samra, T. (2019). Prevention of air embolism during hysteroscopy. Anaesthesia, Pain & Intensive Care. Retrieved from https://mail.apicareonline.com/index.php/APIC/article/view/678
Section
Correspondence

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