Professional paper

Suspected chyle leak during complex spine surgery A unique case of propofol infusion resulting in lipid emulsion pooling in the surgical field

CHARLES THOMAS WASS ; Departments of Orthopedic Surgery, Thoracic Surgery and Anesthesiology, Mayo College of Medicine, Mayo Clinic, 200 First Street, S.W., Rochester, MN 55905, USA
TONY ROCCISANO ; Departments of Orthopedic Surgery, Thoracic Surgery and Anesthesiology, Mayo College of Medicine, Mayo Clinic, 200 First Street, S.W., Rochester, MN 55905, USA
STEPHEN DAVID CASSIVI ; Departments of Orthopedic Surgery, Thoracic Surgery and Anesthesiology, Mayo College of Medicine, Mayo Clinic, 200 First Street, S.W., Rochester, MN 55905, USA
MARK BENEDICT DEKUTOSKI ; Departments of Orthopedic Surgery, Thoracic Surgery and Anesthesiology, Mayo College of Medicine, Mayo Clinic, 200 First Street, S.W., Rochester, MN 55905, USA
MICHAEL JOHN BROWN ; Departments of Orthopedic Surgery, Thoracic Surgery and Anesthesiology, Mayo College of Medicine, Mayo Clinic, 200 First Street, S.W., Rochester, MN 55905, USA

Abstract

The authors report a case of propofol infusion being mistaken for chyle during a two stage thoracic spinal fusion. Propofol is commonly used during spine surgery to facilitate neuromonitoring and there are no reported cases of these observations in the spine literature. We describe the positioning, timing, and treatment in a patient that required prolonged care to rule out a chylothorax. Chyle and the pharmacologic and physiologic effects of propofol are discussed. This review outlines our reasoning and steps used to rule out a chyle leak in the setting of propofol-based anesthesia.

Keywords

chest tube; chylothorax; motor evoked potential monitoring; neuromonitoring; propofol infusion syndrome; PRIS; thoracic duct; thoracotomy; total intravenous anesthesia; TIVA

Hrčak ID:

108798

URI

https://hrcak.srce.hr/108798

Publication date:

1.4.2013.

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