Acute hemodynamic instability during alcohol ablation of symptomatic vertebral hemangioma: a prospective study

Symptomatic vertebral hemangiomas (SVH) are difficult to treat and many therapeutic options, including surgery, radiotherapy, arterial embolization, and injection of methyl-methacrylate into hemagiomatous vertebrae have been reported. Alcohol ablation of vertebral hemangiomas is an effective management option; however, a literature search did not reveal any reports of anesthetic complications or hemodynamic instability during and report a series of four males and seven females and report hemodynamic variations observed at the time of injection of absolute ethanol under general anesthetic, for the treatment of SVH. The median age of the patients was 20 years (range, 10-36 years), and median weight was 45 kg (range, 30-70 kg). All patients developed transient hypotension and bradycardia at the time of alcohol injection (8-10 mL of absolute alcohol). No patient required intervention with vagolytics or vasopressors. It is likely that the administration of alcohol in small aliquots prevented any major consequences. Moreover, patients under general anesthesia are at lower risk than those receiving monitored sedation, with better control over hemodynamics.