Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Respiratory acidosis and subcutaneous emphysema during laparoscopic cholecystectomy

  • 666 Accesses

  • 28 Citations


A case is presented of a healthy 69-yr-old woman who underwent elective laparoscopic cholecystectomy under general anaesthesia. As surgery proceeded she developed hypercapnia (arterial blood PaCO2 = 100 mmHg) and a related respiratory acidosis (arterial blood pH 7.07). The cause was attributed to subcutaneous insufflation and absorption of CO2, directly related to the surgical pneumoperitoneum.


Une patiente bien portante de 69 ans est opérée en chirurgie réglée pour une cholécystectomie par laparoscopie. Pendant l’intervention, elle présente de l’hypercapnie (PaCO2 = 100 mmHg) associée à une acidose respiratoire (pHa = 7,07). L’étiologie de cet incident est attribuable à une insufflation percutanée avec absorption de CO2 causée par un pneumopéritoine d’origine chirurgicale.


  1. 1

    Rose DK, Cohen MM, Soutter DI. Laparoscopic cholecystectomy: the anaesthetist’s point of view. Can J Anaesth 1992; 39: 809–15.

  2. 2

    Marco AP. Anaesthesia for a patient undergoing laparoscopic cholecystectomy. Anesthesiology 1990; 73: 1268–70.

  3. 3

    Coombs DW, Hooper D, Cohort T. Pre-anesthetic cimetidine alteration of gastric fluid volume and pH. Anesth Analg 1979; 58: 183–8.

  4. 4

    Shulman D, Aronson HB: Capnography in the early diagnosis of carbon dioxide embolism during laparoscopy. Can Anaesth Soc J 1984; 31: 455–9.

  5. 5

    Versichelen L, Serreyn R, Roily G, Vanderkerckhove D. Physiopathologic changes during anesthesia administration for gynecologic laparoscopy. J Reprod Med 1984; 29: 697–700.

  6. 6

    Nyarwaya JB, Samii K, Mazoit JX, De Wattevill JC. Are pulse oximetric and capnographic monitoring reliable during laparoscopic surgery for cholecystecomy? Anesthesiology 1991; 75: A453.

  7. 7

    Bain JA, Spoerel WE. Flow requirements for a modified Mapleson D system during controlled ventilation. Can Anaesth Soc J 1973; 20: 629–36.

Download references

Author information

Correspondence to Derek J. Pearce.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Pearce, D.J. Respiratory acidosis and subcutaneous emphysema during laparoscopic cholecystectomy. Can J Anaesth 41, 314 (1994). https://doi.org/10.1007/BF03009911

Download citation

Key words

  • carbon dioxide: absorption, hypercarbia
  • complications: hypercapnia, emphysema
  • surgery: laparoscopy