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Asystole During Elective Cervical Spine Surgery: A Case Study.
Kathleen R Wren1, Timothy L Wren2
1is a Certified Registered Nurse Anesthetist and nurse anesthesia emphasis program director at the College of Nursing, University of Wisconsin Oshkosh with a clinical practice at Ascension NE Wisconsin Mercy and St Elizabeth Hospitals in Oshkosh and Neenah, Wisconsin.
AANA Journal
|January 25, 2022
Summary
Sudden cardiac arrest (asystole) occurred during cervical spine surgery. This case highlights immediate recognition and treatment of this critical event.
Area of Science:
- Anesthesiology
- Neurosurgery
- Cardiology
Background:
- Anterior cervical discectomy and fusion (ACDF) is a common spinal procedure.
- Asystole, a life-threatening cardiac event, can occur unexpectedly during surgery.
- Patient safety during ACDF requires vigilance for potential complications.
Purpose of the Study:
- To review potential causes of asystole during cervical spinal surgery.
- To discuss anatomical considerations relevant to managing asystole during dissection and retraction.
- To evaluate the timely recognition and management of asystole in a surgical patient.
Main Methods:
- Case report of a 52-year-old ASA class II patient undergoing C3-C4 ACDF.
- Analysis of the intraoperative event of sudden asystole during retractor placement.
- Review of literature regarding asystole during cervical spinal procedures.
Main Results:
- Asystole occurred instantaneously upon placement of retractors.
- The case underscores the importance of prompt identification and intervention for asystole.
- Management strategies were implemented to address the cardiac event.
Conclusions:
- Asystole during ACDF can be triggered by surgical manipulation.
- Understanding anatomical relationships is crucial for managing intraoperative asystole.
- Rapid response protocols are essential for improving outcomes in patients experiencing asystole during surgery.
