Bilateral mydriasis during laparoscopic surgery.
Peritoneal insufflation with CO2 has been associated with profound cardiorespiratory disturbances, which may modify cerebral blood flow (CBF), particularly in hypertensive patients in whom CBF autoregulation is altered. We report a case of bilateral mydriasis during laparoscopic gastrectomy in a patient with chronic hypertension followed by a coma lasting several hours and we shortly discuss the possible mechanisms involved.
Dumont
L
L
Department of Anaesthesiology, Hôpital Cantonal Universitaire de Genève, Switzerland.
Mardirosoff
C
C
Dumont
C
C
Mattys
M
M
Tassonyi
E
E
D002245:Carbon Dioxide / Q000009:adverse effects / Q000097:blood / Q000378:metabolism; D002560:Cerebrovascular Circulation / Q000502:physiology; D002908:Chronic Disease; D003128:Coma / Q000209:etiology; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D007327:Insufflation / Q000009:adverse effects; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D015878:Mydriasis / Q000209:etiology*; D010437:Peptic Ulcer / Q000601:surgery
D002245:Carbon Dioxide