skip to main content

PEA Arrest During Laparoscopy — FRCA Final MCQ

Instant feedback + full explanation. One question, done properly.

ModerateAnaesthetic Equipment & SafetyPEA Arrest During LaparoscopyFRCA Final

A 55-year-old man develops pulseless electrical activity (PEA) cardiac arrest during a laparoscopic cholecystectomy under general anaesthesia. CPR is commenced. Which reversible cause specific to laparoscopic surgery must be addressed immediately?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Hypovolaemia from liver laceration only

During laparoscopic surgery, PEA arrest has a specific reversible cause: pneumoperitoneum must be immediately released (desufflate the abdomen) as elevated intra-abdominal pressure reduces venous return and cardiac output. This is in addition to considering the standard 4 H's and 4 T's. Other laparoscopy-specific causes include: gas embolism (CO2), vagal response to peritoneal stretching, tension pneumothorax (from diaphragmatic injury), and occult haemorrhage. Desufflation should be performed immediately upon recognition of cardiac arrest during laparoscopy.

Reference: Resuscitation Council UK – 2021 – Special circumstances: cardiac arrest during anaesthesia; AAGBI – 2020 – Laparoscopic surgery