Two cases of pulmonary embolism in spinal surgeries

We experienced two cases of pulmonary embolism (PE) in the perioperative period. Although the incidence of perioperative PE is low, it may lead to a critical outcome. The first case is a 59-year-old man without risk factors of PE, scheduled for laminectomy. The end tidal CO2 of 25 mmHg and Pa(CO2) of 48 mmHg developed at the same time during the operation, suggesting PE. He was diagnosed as PE by pulmonary perfusion scan later. The second case was a 71-year-old woman with hypertension and diabetes mellitus, scheduled for laminectomy. Although there were no events during the surgery, she complained of chest pain and dyspnea after the operation. Blood gas analysis showed Pa(O2) of 55 mmHg (FI(O2) 0.4). She was also diagnosed as PE by pulmonary perfusion scan. Both patients made satisfactory progress by appropriate diagnosis and treatment. PE may occur in spite of prevention, and it is important to find out the signs of PE and to prepare for the occurrence of PE.