Miyamoto Y, Higuchi A, Kamitani K, Shakunaga K
Department of Anesthesia, Toyama Red Cross Hospital.
Masui. 1992 Aug;41(8):1311-3.
A 28-year-old female was scheduled for laparoscopy under general anesthesia. Her history and physical examination were unremarkable. Trachea was intubated uneventfully following intravenous administration of thiopental 200 mg and vecuronium 8 mg. Anesthesia was maintained with 40% O2, 60% N2O and sevoflurane. Shortly after pneumoperitoneum was introduced, airway resistance increased and breathing sounds were hardly audible over the right side of the chest. A chest radiograph showed the right pneumothorax. Immediately after evacuating the peritoneal gas, the chest radiograph and a blood gas analysis showed that the pneumothorax had improved. Pneumothorax can occur subsequently to pneumoperitoneum due to passage of gas through weak points or defects in the diaphragm. Breathing sound should be monitored carefully during the laparoscopic surgery. Anesthetic gas analyzer and capnometer are considered to be useful to confirm the cause of the pneumothorax.
一名28岁女性计划在全身麻醉下进行腹腔镜检查。她的病史和体格检查均无异常。静脉注射200毫克硫喷妥钠和8毫克维库溴铵后，气管插管顺利。麻醉维持采用40%氧气、60%氧化亚氮和七氟醚。气腹建立后不久，气道阻力增加，右侧胸部呼吸音几乎听不到。胸部X光片显示右侧气胸。排出腹腔气体后，胸部X光片和血气分析立即显示气胸有所改善。气腹后可能因气体通过膈肌薄弱点或缺损处而导致气胸。腹腔镜手术期间应仔细监测呼吸音。麻醉气体分析仪和二氧化碳监测仪被认为有助于确定气胸的原因。
