Nitrogen gas embolism as a potential complication of cryosurgery for bone tumours. Issue 1 (8th January 2018)

• Record Type: Journal Article
• Authors: Vanamail, Prasanna Vani; Balakrishnan, Kalpana
• Is Part Of: Anaesthesia cases. Volume 6:Issue 1(2018)
• Page Start: 5
• Page End: 9
• Publication Date: 2018-01-08
• Subjects: 617.9605
• DOI: 10.21466/ac.ACRONGE.2018
• Languages: English
• ISSNs: 2396-8397

Abstract

Summary: Anaesthetic implications of cryosurgery for bone tumours have not been well described. We report a case of a patient undergoing cryosurgery with liquid nitrogen. Upon thawing to body temperature, liquid nitrogen can expand to produce a large volume of gas, predisposing to embolism. Our patient developed sudden oxygen desaturation and a fall in end‐tidal carbon dioxide during fixation of the liquid nitrogen‐treated bone, which was consistent with a diagnosis of venous gas embolism. Real‐time end tidal nitrogen analysis and haemodynamic monitoring help in early detection. Management entails venting out the gas, delivering 100% oxygen and providing cardiovascular support. We conclude that nitrogen gas embolism is a potential complication during pedicle cryosurgery with liquid nitrogen.