Related Experiment Videos
Metformin-associated lactic acidosis after elective cervical spine fusion: a case report
Simon C Mears1, Pamela A Lipsett, Myles D Brager
1R. Adams Cowley Shock Trauma Center, University of Maryland Medical Systems, Baltimore, USA.
Study Design:
A case of metformin-associated lactic acidosis after elective spinal surgery is reported.
Objective:
To inform spinal surgeons of this potentially fatal side effect and make them aware that metformin should be stopped 48 hours before surgery.
Summary Of Background Data:
Metformin is a commonly used oral hypoglycemic agent used in the treatment of non-insulin-dependent diabetes mellitus. A rare side effect of metformin is lactic acidosis, which has a 50% mortality rate. Risk factors for metformin-associated lactic acidosis include renal, hepatic, and cardiac failure. Two cases have been reported in postsurgical patients. No cases of this disorder have been reported after orthopedic procedures.
Methods:
A patient who developed metformin-associated lactic acidosis after cervical spinal fusion is presented.
Results:
Recognition of the cause and aggressive medical management led to resolution of the lactic acidosis. Subsequent surgery was uneventful when metformin was discontinued more than 48 hours before surgery.
Conclusion:
Spinal surgeons should be aware of this preventable, potentially fatal side effect and stop metformin 48 hours before surgery.