Intensive Care Unit, University Hospital of Guadalajara, Spain.
Obstetrics and Gynecology department, University Hospital of Guadalajara, Spain.
J Gynecol Obstet Hum Reprod. 2022 Oct;51(8):102431. doi: 10.1016/j.jogoh.2022.102431. Epub 2022 Jun 17.
Uterine myomas are the most common benign uterine tumors. Hysteroscopic myomectomy has grown as a standard minimally invasive surgical procedure, but this technique is not free from complications.
An hysteroscopic myomectomy was performed on a 38 years-old woman. During the awakening after the procedure, she presented focal neurological deficits, thus arterial blood gas test and total body computerized tomography (CT) scan were urgently carried out. They revealed a very high carboxyhemoglobin level and abdominal venous air embolism. The patient stayed in Trendelenburg position and under mechanical ventilation with 100% oxygen concentration. Fortunately, a few hours later she was fully awake and was able to be successfully extubated, being discharged to the surgical ward three days later fully recovered.
Carbon monoxide poisoning during hysteroscopic resection is a rare but potentially fatal complication that anesthetists, gynecologists, and critical care physicians should be aware of.
子宫肌瘤是最常见的良性子宫肿瘤。宫腔镜子宫肌瘤切除术已成为一种标准的微创手术，但该技术并非没有并发症。
一名 38 岁女性接受了宫腔镜子宫肌瘤切除术。在术后苏醒过程中，她出现了局灶性神经功能缺损，因此紧急进行了动脉血气检查和全身计算机断层扫描（CT）。结果显示极高的碳氧血红蛋白水平和腹部静脉空气栓塞。患者保持在特伦德伦伯格体位，接受 100%浓度氧气的机械通气。幸运的是，几个小时后她完全清醒，成功拔管，三天后完全康复出院到外科病房。
宫腔镜切除术中发生的一氧化碳中毒是一种罕见但潜在致命的并发症，麻醉师、妇科医生和重症监护医生应有所了解。
