Venous air embolism can occur in the various situations during operation. We experienced a case of cardiac arrest due to iatrogenic venous air embolism. A 62 year old man was underwent thoracotomy for lung cancer with one lung ventilation in the left lateral decubitus position. Finished right upper lobectomy, surgeon insufflated air into intraabdominal cavity through diaphragm to reduce dead spacce of thoracic cavity. After insufflating air, blood pressure and heart rate dropped suddenly and then cardiac arrest was developed immediately. We performed cardiac resuscitation with mannual cardiac compression, various cardiotonic drugs and removal of air through opened right atrium, and resulted in good hemodynamic recovery. At the time of discharge, the patient has recovered almost completely with mild short term memory loss and hoarseness.
Blood Pressure ; Cardiotonic Agents ; Diaphragm ; Embolism, Air* ; Heart Arrest ; Heart Atria ; Heart Rate ; Hemodynamics ; Hoarseness ; Humans ; Insufflation* ; Lung Neoplasms ; Memory Disorders ; Middle Aged ; One-Lung Ventilation ; Resuscitation ; Thoracic Cavity ; Thoracotomy

Eisenmenger' syndrome is defined as pulmonary hypertention with right-to-left or bidirectional shunt with peripheral cynosis. All patients with Eisenmenger' syndrome are at markedly increased risk and poor prognosis. We experienced a case of 31-year-old, pregnancy 36 weeks with Eisenmenger's syndrome secondary to PDA and Down syndrome. We carefully performed epidural anesthesia with fractionated doses of 2 % lidocaine and fentanyl. The sensory block reached to T6 level. Monitoring included ECG, invasive blood pressure, finger pulse oximetry and central venous pressure. Blood pressure was maintained with intravenous phenylephrine. Blood loss was promptly replaced with crystalloid solution and FFP. Postoperative pain was managed successfully with continuous epidural infusion of 0.2 % bupivacaine and fentanyl. The mother and baby were discharged home 1 week later without complicaton.
Adult ; Anesthesia, Epidural* ; Blood Pressure ; Bupivacaine ; Central Venous Pressure ; Cesarean Section* ; Down Syndrome ; Eisenmenger Complex* ; Electrocardiography ; Female ; Fentanyl ; Fingers ; Humans ; Lidocaine ; Mothers ; Oximetry ; Pain, Postoperative ; Phenylephrine ; Pregnancy ; Prognosis