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Propofol lipemia mimicking chyle leak during neck dissection
Author(s) -
Vokes David E.,
Linskey Mark E.,
Armstrong William B.
Publication year - 2006
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20472
Subject(s) - chyle , propofol , medicine , neck dissection , anesthesia , leak , surgery , dissection (medical) , complication , carcinoma , environmental engineering , engineering
Background Propofol is an intravenous agent used in anesthesia. Lipemia is an uncommon adverse effect of propofol infusion. Methods A patient undergoing neck dissection for recurrent chordoma had intraoperative lipemia develop after prolonged propofol infusion. Results Lipemia gave blood in the surgical field a milky appearance resembling chyle, but no chyle leak was present. Lipemia was confirmed by drawing a sample of blood and leaving it to stand. Layering of the blood with a milky white upper layer was observed. Analysis of a second sample of blood revealed a high lipemic index. Conclusions Lipemia is an uncommon adverse effect of propofol infusion, which may give blood a milky appearance and be confused for a chyle leak in a dissected neck. Identification of lipemia is also important because there is a risk of acute pancreatitis, and it may represent the early stage of propofol infusion syndrome. © 2006 Wiley Periodicals, Inc. Head Neck, 2006