Cerebral gas embolism in a patient without right-to-left shunt after robotic partial nephrectomy
Abstract Background Cerebral gas embolism is a rare but serious complication of laparoscopic surgeries, the risk of which is increased by the presence of right-to-left shunt. A case of cerebral gas embolism after robotic partial nephrectomy is presented. Case presentation A 71-year-old man underwent...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2025-05-01
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| Series: | JA Clinical Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40981-025-00793-w |
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| Summary: | Abstract Background Cerebral gas embolism is a rare but serious complication of laparoscopic surgeries, the risk of which is increased by the presence of right-to-left shunt. A case of cerebral gas embolism after robotic partial nephrectomy is presented. Case presentation A 71-year-old man underwent robotic partial nephrectomy. During tumor resection, end-tidal CO₂ (ETCO₂) decreased from 42 to 34 mmHg, followed by a decrease in mean arterial pressure (MAP) to < 65 mmHg and oxygen saturation (SpO₂) to 95%. Postoperatively, he exhibited delayed emergence from anesthesia and left conjugate gaze deviation. Neuroimaging revealed cerebral gas embolism. A bubble test performed by a cardiologist under positive pressure ventilation ruled out right-to-left shunt. Despite postoperative treatment, the patient became bedridden with severe neurological sequelae. Conclusions Cerebral gas embolism can occur during robotic procedures even without right-to-left shunt. Anesthesiologists must promptly recognize intraoperative signs of this complication and initiate timely interventions to prevent severe complications. |
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| ISSN: | 2363-9024 |