[Carbon dioxide embolism during hysteroscopy followed by transient blindness]

Ann Fr Anesth Reanim. 1996;15(2):192-5. doi: 10.1016/0750-7658(96)85042-8.
[Article in French]

Abstract

A 43 year-old woman, with uterine bleeding and right ovary cyst, was scheduled for hysteroscopy-curettage and laparoscopy. Her history was unremarkable. After induction of general anaesthesia and tracheal intubation (propofol, fentanyl, vecuronium), anesthesia was maintained with N2O/O2 (60%/40%) and isoflurane 1 vol %. The patient was placed in the dorsal lithotomy position. Two minutes after the beginning of CO2 insufflation for hysteroscopy, a ventricular tachycardia with a circulatory arrest suddenly occurred. Insufflation was stopped, cardiopulmonary resuscitation started and lignocaine 100 mg iv administered. The haemodynamic status improved rapidly with a return to sinusal rhythm and stable blood pressure within two minutes. In the recovery room, the patient was restless and experienced blindness for 3 hours. Physical examination and all investigations (EEG, brain CT scan, carotid Doppler and transoesophageal echocardiography) were normal. The most probable diagnosis was a CO2 venous embolism associated with an arterial paradoxal embolism responsible for the temporary blindness.

Publication types

  • Case Reports
  • English Abstract
  • Review

MeSH terms

  • Adult
  • Blindness / etiology*
  • Carbon Dioxide*
  • Embolism, Air / etiology*
  • Female
  • Humans
  • Hysteroscopy / adverse effects*
  • Hysteroscopy / methods
  • Tachycardia, Ventricular / etiology

Substances

  • Carbon Dioxide