Canadian Journal of Anesthesia, Vol 15, 297-299, Copyright © 1968 by Canadian Anesthesiologists' Society

Massive Pulmonary Embolism Occurring during Anaesthesia: Report of Three Cases

¹ Department of Anaesthesia, St. Boniface General Hospital, St. Boniface, Manitoba; Department of Anaesthesia, University of Manitoba

Three cases of massive pulmonary embolus during anaesthesia have been presented. This catastrophe occurred in patients whose preoperative course of bed confinement had set the stage for the possible development of a pulmonary embolus. Two patients developed signs immediately following induction of anaesthesia and one during manipulation of the common iliac vein. An abrupt development of deep cyanosis, unrelieved by ready ventilation of all lung fields with 100 per cent oxygen, in a patient who might be a candidate for pulmonary embolus should evoke the thought of this possibility. The persistence of a palpable peripheral pulse eliminates a primary diagnosis of sudden heart arrest. Steps should be taken to make a swift diagnosis so that definitive treatment may be considered. Finally, these cases emphasize, as Jacoby et al.³ have pointed out, the importance of not accepting responsibility for a death associated with anaesthesia without a thorough post-mortem examination.