A 70-year-old male presented with multiple lesions on his pancreas (Figure 1). The patient had undergone a right nephrectomy to treat renal cell carcinoma five years before. His medical history was positive for dyslipidemia but negative for diabetes. Tumor characteristics: Multiple hypovascular tumors Swollen lymph nodes Tumor evaluation revealed them to be pancreatic metastases of RCC Treatment The patient underwent a total pancreatectomy using fentanyl as anesthesia. Immediate postoperative ABG was normal.
He was transferred to the ICU, where he became unconscious. High-volume oxygenation was initiated due to low O2 saturation (34%). After the patient regained consciousness, an ABG was carried out. Elevated pCO 2 (42.6 mmHg) and HCO 3 (22.1 Eq/L) Elevated lactate and glucose concentrations – 2.6 mmol/L and 236 mg/dL, respectively Administration of fentanyl was stopped to improve…
