Pulmonary edema after shoulder arthroscopy in an old female under general anesthesia

Abstract

A number of complications have been ascribed to shoulder arthroscopy, but pulmonary edema is rarely reported. A 64-year-old female underwent right shoulder arthroscopic repair for supraspinatus and subscapular tears under intermuscular sulcus brachial plexus block (ISBPB) and general anesthesia. Finishing suture of torn tendon, and acromion and distal clavicle plasty, the patient represented the symptoms of dyspnea, and oxygen saturation quickly dropped to 80% without oxygen supply. After inhaled oxygen, the oxygen saturation quickly returned to 95%, while dyspnea didn’t improve. Noticing swelling in neck and chest, left movement of the trachea, low breath sounds and wet rales during auscultation, ultrasound examination was performed and found the obvious pleural slip, and a large number of b-lines in the lung, indicating pulmonary edema. After injection of furosemide and dexamethasone (i.v.), the outcome of patient was satisfactory. This is the first report of pulmonary edema as a complication of shoulder arthroscopy, which also reviews the relevant factors of fluid extravasation, and highlights the good use of the equipment at hand to quickly judge the patient's condition.

Keywor: ultrasound; shoulder arthroscopic surgery; pulmonary edema; B-line; Furosemide