Suspected chyle leak during complex spine surgery a unique case of propofol infusion resulting in lipid emulsion pooling in the surgical field

Abstract

The authors report a case of propofol infusion being mistaken for chyle during a two stage thoracic spinal fusion. Propofol is commonly used during spine surgery to facilitate neuromonitoring and there are no reported cases of these observations in the spine literature. We describe the positioning, timing, and treatment in a patient that required prolonged care to rule out a chylothorax. Chyle and the pharmacologic and physiologic effects of propofol are discussed. This review outlines our reasoning and steps used to rule out a chyle leak in the setting of propofol-based anesthesia.