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KMID : 1001920120510030173
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Journal of Korean Neurosurgical Society
2012 Volume.51 No. 3 p.173 ~ p.176
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An Acute Postoperative Intractable Hyperventilation after an Endoscopic Third Ventriculostomy
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Lee Hae-Mi
Shin Kyung-Bae
Kim Seong-Ho
Jee Dae-Lim
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Abstract
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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 EtCO2, 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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KEYWORD
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Central neurogenic hyperventilation, Endoscopic third ventriculostomy, Sedation
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