We experienced a case of massive subcutaneous emphysema and marked hypercarbia during a laparoscopic assisted distal gastrectomy. Forty minutes after the start of pneumoperitoneum, the end-tidal carbon dioxide (CO2) tension was raised rapidly up to 70 mmHg. At this time, subcutaneous emphysema was detected on the neck and anterior chest of the patient. Carbon dioxide insufflation was then stopped, and surgery was restarted when the end-tidal CO2 level was normalized. During a second laparoscopic trial, the patient developed hypercarbia unresponsive to marked hyperventilation. As the laparoscopic procedure terminated, the end-tidal CO2 level no longer increased. Subcutaneous emphysema remained even at the recovery room. The patient was transferred to a ward in the usual procedure, and was discharged uneventfully nine days thereafter.
Malignant hyperthermia masked by capnographic monitoring.
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Subcutaneous emphysema associated with laparoscopy.
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Hemodynamic changes during laparoscopic cholecystectomy.
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(1997) Subcutaneous emphysema and hypercarbia following laparoscopic cholecystectomy by increased intraabdominal pressure,
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(2002) Massive subcutaneous emphysema and hypercarbia: complications of carbon dioxide absorption during extraperitoneal and intraperitoneal laparoscopic surgery,
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Pulmonary CO2 elimination during surgical procedures using intra- or extraperitoneal CO2 insufflation.
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Analysis of the hemodynamic and ventilatory effects of laparoscopic cholecystectomy,
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(1995) Correlation between PaCO2 and PETCO2 during laparoscopic cholecystectomy,