Department of Anesthesiology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
Department of Anesthesiology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
J Perianesth Nurs. 2021 Dec;36(6):606-611. doi: 10.1016/j.jopan.2021.03.011. Epub 2021 Nov 3.
The purpose of this case study and review was to understand the perianesthestic care of paradoxical air embolism (PAE) in patients undergoing hysteroscopic surgery. The perianesthestic management record of a patient undergoing hysteroscopic surgery was analyzed to study the characteristics of PAE, and the literature describing the perianesthestic care for PAE was reviewed. The first symptom of PAE in hysteroscopic surgery is often a decrease in end-tidal carbon dioxide (ETCO), and the complications include embolism of the pulmonary artery, coronary artery, and cerebral artery. The best monitoring method is continuous ETCO monitoring, and intraoperative echocardiography is an excellent method to diagnose and guide the treatment of PAE. PAE is a rare but serious complication of hysteroscopic surgery that is associated with organ ischemia and hypoxia. Prevention and treatment of PAE requires the vigilance and cooperation of not only perianesthesia nurses and anesthesiologists but also the surgeons and operating room nurses. Early prevention, proper monitoring, and effective treatment are the keys to successful rescue for PAE.
本病例研究和综述的目的是了解行宫腔镜手术患者的围术期反常空气栓塞（PAE）的护理。对一例行宫腔镜手术患者的围术期管理记录进行分析，以研究 PAE 的特征，并对描述 PAE 围术期护理的文献进行回顾。宫腔镜手术中 PAE 的首发症状通常为呼气末二氧化碳（ETCO）下降，并发症包括肺动脉、冠状动脉和脑动脉栓塞。最佳监测方法是连续 ETCO 监测，术中超声心动图是诊断和指导 PAE 治疗的极好方法。PAE 是宫腔镜手术中一种罕见但严重的并发症，与器官缺血缺氧有关。PAE 的预防和治疗不仅需要围术期护士和麻醉师的警惕和合作，还需要外科医生和手术室护士的参与。早期预防、适当监测和有效治疗是 PAE 成功抢救的关键。
