European Journal of Biomedical and Pharmaceutical Sciences

PULMONARY ASPIRATION WAS DETECTED BY DECREASE IN TRANSCUTANEOUS OXYGEN TENSION DURING SEDATION: A CASE REPORT

*Tomoki Nishiyama MD, PhD

ABSTRACT

Background: We report a case with pulmonary aspiration during surgery under epidural and spinal anesthesia with sedation, whose pulmonary aspiration was suspected by decrease in transcutaneous oxygen tension (tcPO2). Case Report: A 70 years old man received axillo-femoral bypass grafting and thrombendarterectomy of femoral artery under epidural and spinal anesthesia. TcPO2 and transcutaneous carbon dioxide tension (tcPCO2) were monitored at his right chest. Percutaneous oxygen saturation (sPO2) was monitored at the right index finger. He was sedated with midazolam and propofol. Two hours after start of anesthesia, tcPO2 suddenly decreased without remarkable change in SpO2. Arterial oxygen pressure (PaO2) decreased to 73 mmHg from 345 mmHg. Chest computed tomography (CT) after surgery showed consolidation mainly in the right lung, which suggested pulmonary aspiration. Conclusions: TcPO2 was better than SpO2 to detect decrease in PaO2 by pulmonary aspiration during surgery under epidural and spinal anesthesia with sedation.

Keywords: Aspiration pneumonia, transcutaneous oxygen tension, percutaneous oxygen saturation.