We experienced suspected pulmonary thromboembolism or fat embolism syndrome in a patient undergoing osteosynthesis. The patient was 40-year-old man with a left open femoral fracture caused by crash trauma Surgery was scheduled 2 days after admission to the hospital. Induction of anesthesia was smooth and the patient's posture was supine. An intramedullary nail was inserted 1 hour after the start of surgery, when oxygen saturation and blood pressure decreased. However, heart rate was stable, and right heart strain or skin findings were not observed. Hemodynamic parameters were gradually stabilized by blood transfusion. However, when body posture was returned to the prone position after surgery, oxygen saturation and blood pressure decreased again. On the following day, a pulmonary embolism was detected by computed tomography. The pathophysiology of bone fractures and related surgical procedures are usually associated with several complications. It is important to distinguish the condition of the patient and correcdy treat sudden decreases of oxygen saturation and blood pressure during surgery in these patients.
|ジャーナル||Japanese Journal of Anesthesiology|
|出版ステータス||出版済み - 7月 2018|
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