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Nonfatal air embolism during shoulder arthroscopy
Vivek Pandey1, Elsa Varghese, Madhu Rao
1Department of Orthopaedics, Kasturba Medical College, Manipal, Karnataka, India. vivekortho@gmail.com
American Journal of Orthopedics (Belle Mead, N.J.)
|June 28, 2013
Summary
Air embolism is a rare complication of shoulder arthroscopy. Monitoring end-tidal carbon dioxide aids early detection during procedures for acute shoulder fractures.
Area of Science:
- Orthopedic Surgery
- Vascular Surgery
- Anesthesiology
Background:
- Shoulder arthroscopy is a common procedure for shoulder injuries.
- Air embolism is a rare but serious complication.
- Acute bony Bankart lesions and greater tuberosity avulsions often require arthroscopic intervention.
Observation:
- A patient developed a venous air embolism during shoulder arthroscopy for acute fractures.
- The event occurred immediately after joint insufflation with air.
- Diagnosis was confirmed by decreased end-tidal carbon dioxide, hypotension, and a mill wheel murmur.
Findings:
- The patient experienced a nonfatal air embolism.
- Supportive treatment led to full recovery without complications.
- End-tidal carbon dioxide monitoring proved crucial for early detection.
Implications:
- Highlights the risk of air embolism during shoulder arthroscopy for acute fractures.
- Emphasizes the importance of vigilance and monitoring for this complication.
- Suggests end-tidal carbon dioxide monitoring as a key diagnostic tool.
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