Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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An Acute Postoperative Intractable Hyperventilation after an Endoscopic Third Ventriculostomy

  • Lee, Hae-Mi (Department of Anesthesiology and Pain Medicine, School of Medicine, Yeungnam University) ;
  • Shin, Kyung-Bae (Department of Anesthesiology and Pain Medicine, School of Medicine, Yeungnam University) ;
  • Kim, Seong-Ho (Department of Neurosurgery, School of Medicine, Yeungnam University) ;
  • Jee, Dae-Lim (Department of Anesthesiology and Pain Medicine, School of Medicine, Yeungnam University)
  • Received : 2011.06.13
  • Accepted : 2012.03.12
  • Published : 2012.03.28
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Abstract

This report describes a rare case of postoperative hyperventilation attack after an endoscopic third ventriculostomy in a 46-year-old woman. About 60 min after the termination of the operation, an intractable hyperventilation started with respiratory rate of 65 breaths/min and $EtCO_2$, 16.3 mm Hg. Sedation with benzodiazepine, thiopental sodium, fentanyl, and propofol/remifentanil infusion was tried under a rebreathing mask at a 4 L/min of oxygen. With aggressive sedative challenges, ventilation pattern was gradually returned to normal during the 22 hrs of time after the surgery. A central neurogenic hyperventilation was suspected due to the stimulating central respiratory center by cold acidic irrigation solution during the neuroendoscopic procedure.

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References

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