gas embolism
Life-threatening complication where CO₂ enters the vascular system during laparoscopic surgery.
Full Definition
Gas embolism is a rare but potentially fatal complication of laparoscopic surgery that occurs when CO₂ from the pneumoperitoneum enters the circulatory system, either venous or arterial. This can happen through direct intravascular injection during trocar insertion, inadvertent insufflation into a blood vessel, or massive absorption through injured tissue surfaces. Clinical manifestations include sudden cardiovascular collapse, arrhythmias, hypotension, and characteristic mill-wheel murmur on auscultation. Immediate management includes stopping CO₂ insufflation, placing the patient in left lateral decubitus position with head down, and supportive cardiovascular care. The use of CO₂ rather than air for insufflation reduces the severity of embolism due to CO₂'s higher solubility in blood.
Usage
Usage note: Distinguish from air embolism; specify CO₂ embolism when referring to laparoscopic complications.
In Context
- "The sudden drop in blood pressure and end-tidal CO₂ suggested gas embolism during trocar insertion." — Anesthesia complication report
- "Gas embolism was suspected when the patient developed a mill-wheel murmur during laparoscopic insufflation." — Critical incident analysis