Perioperative Respiratory Compromise in Patients Undergoing PCNL-A Case Series 2310-2312
Dr. S. Ponnambala Namasivayam,
Professor, Department of Anaesthesiology, Goverment Stanley Medical College and Hospital, Chennai, India.
Phone: 9444451853, E-mail: email@example.com
Percutaneous Nephrolithotomy (PCNL) is a surgical procedure which is used to extract renal pelvic stones. An optimum access tract, without traumatizing the surrounding structures, is essential for the surgery. Trauma to the surrounding structures and extraâ€“vasation of the irrigating fluid may result in complications like hydrothorax, pneumothorax, hydro pneumothorax etc. These complications may produce intraâ€“ operative respiratory compromise leading on to arterial hypoxemia and its sequelae. A series of three case reports with review is presented here. First case is accumulation of irrigating fluid in the pleura causing hydrothorax and oxygen desaturation. Second case is extraâ€“vasation of fluid in the abdominal wall and the patient was ventilated artificially for 24 hours. Third patient developed pneumothorax and he needed chest drainage.PCNL is done under general anaesthesia in prone position. The anaesthesiologist should be vigil enough to identify the situation and take appropriate measures to correct it.