Vokes DE, Linskey ME, Armstrong WB. Propofol lipemia mimicking chyle leak during neck dissection.
Head Neck 2006;
28:1147-9. [PMID:
16983690 DOI:
10.1002/hed.20472]
[Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
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.
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