title: Fatal gas embolism during ureteroscopic holmium: yttrium-aluminium-garnet laser lithotripsy under spinal anesthesia - a case report.
abstract: Ureteroscopic holmium: yttrium-aluminium-garnet (Ho:YAG) laser lithotripsy is an excellent treatment modality, especially for a large impacted ureteral stone. The treatment is efficient and safe. It helps surgeons to carry out a minimally invasive lithotripsy instead of an open surgery in patients with ureteral calculi. Here, we present the first report of a fatal gas embolism that occurred during ureteroscopic Ho:YAG laser lithotripsy under spinal anesthesia. When this complication occurs, the correct crisis resolution protocols, such as prevention of further air entry, reduction in the volume of air entrained, well-hydration, and rapid initiation of cardiopulmonary resuscitation with administering inotropic drugs, are highly effective in the critical period.
authors.affiliation: Departments of Anesthesiology and Urology, Show-Chwan Memorial Hospital, Changhua, Taiwan, ROC.
authors.forename: Chung-Pei
authors.initials: CP
authors.lastname: Chang
authors.forename: Chuang-Chyun
authors.initials: CC
authors.lastname: Liou
authors.forename: Ya-Ling
authors.initials: YL
authors.lastname: Yang
authors.forename: Maw-Sheng
authors.initials: MS
authors.lastname: Sun
mesh_terms: D000368:Aged; D000775:Anesthesia, Spinal; D004618:Embolism, Air / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D053844:Lasers, Solid-State / Q000009:adverse effects; D017602:Lithotripsy, Laser / Q000009:adverse effects* / Q000379:methods; D014514:Ureteral Calculi / Q000628:therapy; D018666:Ureteroscopy / Q000009:adverse effects*