A rare anesthetic complication involving central line access during lumbar spine surgery: a case report and review.

Study Design: A case report describing a rare perioperative complication involving the intrathoracic placement of a central venous catheter during spine surgery leading to hemodynamic instability.

Objective: To review the efficacy of central line use in perioperative spine patients and to describe the diagnosis, emergent treatment, and postoperative care of a unique case of intrathoracic extravasation of propofol.

Summary Of Background Data: Although placement of central line access is a safe procedure, complications can occur. A case in which a venous catheter delivering propofol into the thorax has never been documented.

Methods: A 48-year-old woman presented for revision spine surgery, and a central line was placed. After placement of spinal instrumentation, she became hemodynamically unstable secondary to mediastinal compression caused by pressure from intraoperative propofol and fluid insufflation.

Results: A chest tube was placed, and with aggressive pulmonary toilet and physical therapy, she did well and was discharged without noted symptoms.

Conclusion: The efficacy of central line use should be carefully considered in perioperative spine surgery, and in patients with significant risk factors, placement of central venous access should be radiographically confirmed.