A case report: Cardiac events during Carboperitoneum: Need to titrate the dose of adrenaline

  • Samiksha Parashar, Prakash Shashi, Mandeep M H Madia, Nidhi

Abstract

Laparoscopic cholecystectomy (LapChole) has virtually superseded the more conventional open abdomen approach for the surgical treatment of symptomatic cholelithiasis. LapChole is however not a risk-free procedure and potentially fatal intra-operative complications can occur.Bradycardia followed by cardiac arrest is a reported complication of peritoneum insufflation. And as per ACLS guidelines adrenaline in the dose of 1mg intravenous, every 3-5minutes has been approved as a pharmacologic reserve in cardiac arrest. We present a case report of a patient who suffered from intra-operative cardiac arrest during insufflation of carbon-di-oxide during LapChole and showed signs of myocardial ischemia and arrhythmias after being given adrenaline bolus. Subsequent management, possible aetiology and need to titrate the dose of adrenaline rather than intravenous 1mg bolus has been outlined. She recovered without residual morbidity but the surgery was postponed. Although rare, such complications can be fatal and are thus demanding to the anaesthesiologist.

Published
2019-12-17
Section
Articles