CO2 Gas Embolism Laparoscopy — FRCA Final MCQ

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HardGeneral AnaesthesiaCO2 Gas Embolism LaparoscopyFRCA Final

A patient develops sudden PEA arrest with ETCO2 dropping to zero immediately after laparoscopic peritoneal insufflation to 15 mmHg. Most likely cause?

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Correct answer: C — Massive CO2 embolism

Sudden PEA with abrupt ETCO2 loss immediately after insufflation = massive CO2 gas embolism. CO2 enters open venous channels, creating a gas-lock in the right ventricle obstructing pulmonary outflow. Stop insufflation, desufflate, left lateral head-down (Durant manoeuvre), aspirate via CVC, CPR.

Reference: Association of Anaesthetists – 2023 – Guidelines for safe laparoscopic surgery