Browse > Article
http://dx.doi.org/10.3340/jkns.2012.51.3.173

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)
Publication Information
Journal of Korean Neurosurgical Society / v.51, no.3, 2012 , pp. 173-176 More about this Journal
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.
Keywords
Central neurogenic hyperventilation; Endoscopic third ventriculostomy; Sedation;
Citations & Related Records

Times Cited By Web Of Science : 0  (Related Records In Web of Science)
연도 인용수 순위
  • Reference
1 Reivich M, Cohen PJ, Greenbaum L : Alterations in the electroencephalogram of awake man produced by hyperventilation : effects of 100% oxygen at 3 atmospheres (absolute) pressure. Neurology 16 : 304, 1966
2 Sung HJ, Sohn JT, Kim JG, Shin IW, Ok SH, Lee HK, et al. : Acute respiratory alkalosis occurring after endoscopic third ventriculostomy : a case report. Korean J Anesthesiol 59 : S194-S196, 2010   DOI
3 Tomioka S, Takechi M, Ohshita N, Nakajo N : Propofol is not effective for hyperventilation syndrome. Anesth Analg 92 : 781-782, 2001   DOI   ScienceOn
4 van den Hout MA, Boek C, van der Molen GM, Jansen A, Griez E : Rebreathing to cope with hyperventilation : experimental tests of the paper bag method. J Behav Med 11 : 303-310, 1988   DOI   ScienceOn
5 Walker ML : Complications of third ventriculostomy. Neurosurg Clin N Am 15 : 61-66, 2004   DOI   ScienceOn
6 Adachi YU, Sano H, Doi M, Sato S : Central neurogenic hyperventilation treated with intravenous fentanyl followed by transdermal application. J Anesth 21 : 417-419, 2007   DOI   ScienceOn
7 Fabregas N, LOpez A, Valero R, Carrero E, Caral L, Ferrer E : Anesthetic management of surgical neuroendoscopies : usefulness of monitoring the pressure inside the neuroendoscope. J Neurosurg Anesthesiol 12 : 21-28, 2000   DOI   ScienceOn
8 Folgering H : The pathophysiology of hyperventilation syndrome. Monaldi Arch Chest Dis 54 : 365-372, 1999
9 Foster GT, Vaziri ND, Sassoon CS : Respiratory alkalosis. Respir Care 46 : 384-391, 2001
10 Hales RE, Yudofsky SC : Textbook of clinical psychiatry, ed 4. Washington D.C. : American Psychiatric Publishing Inc, 2003, pp543-565
11 Hansen NB, Nowicki PT, Miller RR, Malone T, Bickers RG, Menke JA : Alterations in cerebral blood flow and oxygen consumption during prolonged hypocarbia. Pediatr Res 20 : 147-150, 1986   DOI   ScienceOn
12 Jaeckle KA, Digre KB, Jones CR, Bailey PL, McMahill PC : Central neurogenic hyperventilation : pharmacologic intervention with morphine sulfate and correlative analysis of respiratory, sleep, and ocular motor dysfunction. Neurology 40 : 1715-1720, 1990   DOI
13 Kim G, Bae JH, Lim SW : Hyperventilation attack during recovery from general anesthesia : a case report. Korean J Anesthesiol 49 : 735-738, 2005   DOI
14 Liebowitz MR, Fyer AJ, Gorman JM, Dillon D, Appleby IL, Levy G, et al. : Lactate provocation of panic attacks. I. Clinical and behavioral findings. Arch Gen Psychiatry 41 : 764-770, 1984   DOI   ScienceOn
15 Mason RJ, Broaddus VC, Martin TR, King TE Jr, Schraufnagel DE, Murray JF, et al. : Murray & Nadel's textbook of respiratory medicine, ed 5. Philadelphia : Saunders Elsevier, 2010, pp1842-1847
16 Mizuno J, Morita S, Itou Y, Honda M, Momoeda K, Hanaoka K : [Hyperventilation syndrome before induction of and after awakening from general anesthesia]. Masui 58 : 768-771, 2009
17 Plum F, Swanson AG : Central neurogenic hyperventilation in man. AMA Arch Neurol Psychiatry 81 : 535-549, 1959   DOI