Laparoscopy is frequent used to assist the diagnosis and treatment of various surgical department. However, complications associated with the procedure including pneumothorax, pneumomediastinum, subcutaneous emphysema, pneumopericardium, and air embolism have been reported. Incidence of subcutaneous emphysema during extraperitoneal laparoscopic surgery has been reported 99%. We report the case of a 76 years old female patient who had subcutaneous emphysema and hypercarbia during retroperitoneal laparoscopic nephrectomy. After developing hypercapnia, we increased the minute ventilation and lowered the CO2 gas insufflation pressure. Until the end of the operation, the patient’s vital signs did not change and end tidal CO2 was not increased any more.

• 조재형(광주기독병원 마취통증의학과) | Jae Hyoung Cho (Department of Anesthesiology and Pain Medicine, Kwangju Christian Hospital, Gwangju, Korea)
• 박천희(광주기독병원 마취통증의학과) | Choen Hee Park (Department of Anesthesiology and Pain Medicine, Kwangju Christian Hospital, Gwangju, Korea) Corresponding author