AI Article Synopsis
- * The patient initially had successful surgery for lumbar spinal canal stenosis, but complications arose during the second stage due to a Mobitz type II atrioventricular block, leading to emergency interventions like percutaneous pacing and temporary pacemaker insertion.
- * The report emphasizes the importance of thorough monitoring of elderly patients during surgery under local anesthesia to quickly address any unexpected emergencies, similar to the precautions taken with general anesthesia.
Article Abstract
Background: Transforaminal full-endoscopic surgery can be performed under local anesthesia, which is safer than general anesthesia, especially in the elderly. However, emergencies can still occur under local anesthesia. We describe a case of cardiac arrest at the start of full-endoscopic spine surgery under local anesthesia.
Case Presentation: The patient was an 80-year-old woman with right lower leg pain caused by two-level lumbar spinal canal stenosis. Two-stage full-endoscopic spine surgery under local anesthesia was planned. The first surgery was completed uneventfully. However, during the second surgery, cardiac arrest occurred because of Mobitz type II atrioventricular block. Percutaneous pacing was started immediately, followed by insertion of a temporary pacemaker via the femoral artery as a life-saving measure. Four days later, a permanent pacemaker was implanted. One month later, the second-stage decompression was completed without complications.
Conclusion: Elderly patients require careful intraoperative monitoring for emergencies during surgery under local anesthesia as under general anesthesia. J. Med. Invest. 71 : 314-319, August, 2024.
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| http://dx.doi.org/10.2152/jmi.71.314 | DOI Listing |
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