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British Journal of Anaesthesia, 2001, Vol. 87, No. 4 644-646
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Case Reports

Cardiac arrest associated with use of an argon beam coagulator during laparoscopic cholecystectomy

M. Kono*,1, N. Yahagi2, M. Kitahara1, Y. Fujiwara1, M. Sha1 and A. Ohmura1

1Department of Anaesthesiology, Teikyo University School of Medicine, Mizonokuchi Hospital, Kawasaki 213-8507, Japan. 2Institute of Environmental Studies, Graduate School of Frontier Science, The University of Tokyo, Japan*Corresponding author

We describe a cardiac arrest during use of an argon beam coagulation (ABC) system in an 82-yr-old woman having laparoscopic cholecystectomy under general and epidural anaesthesia. Intra-abdominal pressure (IAP) was controlled to less than 12 mm Hg during a carbon dioxide gas pneumoperitoneum and at first the operation was uneventful. When the ABC system (gas flow 6 litre min–1) was used to control local bleeding in the liver bed abdominal pressure increased rapidly to over 20 mm Hg and, 1 min later, the end-tidal carbon dioxide decreased to zero, followed by bradycardia and cardiac arrest. At once, an emergency laparotomy was performed and resuscitation begun. A mill-wheel murmur was heard on auscultation, leading to suspicion of argon gas embolism. Fortunately, recovery was completed with no neurological deficit. Anaesthesiologists should consider showed that argon gas embolism can occur with the ABC system during laparoscopic surgery.

Br J Anaesth 2001; 87: 644–6


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