Balki Mrinalini, Manninen Pirjo H, McGuire Glenn P, El-Beheiry Hossam, Bernstein Mark
Department of Anesthesia, The Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Can J Anaesth. 2003 Oct;50(8):835-8. doi: 10.1007/BF03019383.
To report a non-fatal case of intraoperative venous air embolism (VAE) during an awake craniotomy. VAE presented with unusual clinical features.
VAE during an awake craniotomy has not been reported frequently. The patient we describe presented with persistent coughing followed by tachypnea, hypoxia and reduction in end-tidal CO(2) during dural opening while undergoing an awake craniotomy in the supine position. Cardiovascular variables were stable during the episode except for transient hypertension. Having ruled out airway obstruction and low cardiac output, we concluded that air embolism was the cause. The patient responded immediately to the standard treatment of air embolism and recovered without any complication.
This case illustrates a VAE during an awake craniotomy and emphasizes the importance of early diagnosis in the management.
报告1例清醒开颅手术期间发生的非致命性术中静脉空气栓塞（VAE）病例。VAE表现出不寻常的临床特征。
清醒开颅手术期间的VAE报道较少。我们描述的患者在仰卧位进行清醒开颅手术时，在硬脑膜切开期间出现持续咳嗽，随后出现呼吸急促、低氧血症和呼气末二氧化碳分压降低。在此期间，除短暂性高血压外，心血管变量保持稳定。排除气道梗阻和低心输出量后，我们得出空气栓塞是病因的结论。患者对空气栓塞的标准治疗立即产生反应，且康复过程中未出现任何并发症。
该病例说明了清醒开颅手术期间发生的VAE，并强调了早期诊断在治疗中的重要性。
