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Sudden arrhythmia in the prone position during spinal surgery: A case report
Ji Hyun Kim1, Sora Kim, Taeyoung Yu
1Department of Anesthesiology and Pain Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
Medicine
|August 19, 2022
Summary
Sudden arrhythmia occurred during spinal surgery in the prone position despite using a Jackson spine table. The event resolved upon returning to the supine position, suggesting increased intrathoracic pressure as the cause.
Area of Science:
- Cardiovascular Physiology
- Surgical Positioning
- Anesthesiology
Background:
- The prone position is standard for spinal surgery, often requiring reduced lumbar lordosis, which can impact hemodynamics.
- The Jackson spine table is favored for its minimal cardiac effects.
Observation:
- A case of sudden, recurrent arrhythmia during prone positioning with a Jackson spine table is presented.
- Arrhythmia manifested with bizarre P and QRS waves, suspected to be ectopic P waves or bundle branch block.
Findings:
- The arrhythmia spontaneously resolved and recurred, normalizing immediately upon repositioning to supine.
- Increased intrathoracic pressure from the prone position was identified as the likely cause.
Implications:
- Even with specialized tables, prone positioning can precipitate cardiac arrhythmias.
- Understanding physiological changes during prone surgery is crucial for prompt diagnosis and management of hemodynamic complications.
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