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Sudden arrhythmia in the prone position during spinal surgery: A case report

RATIONALE: The prone position is the most commonly required position during spinal surgery. Decreasing lumbar lordosis is necessary to facilitate the accessibility of the surgical field. And this can affect the hemodynamic circulation of the patients. The Jackson spine table is one of the most prefe...

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Autores principales: Kim, Ji Hyun, Kim, Sora, Yu, Taeyoung, Yang, Woo Seok, Hong, Seong Wook
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9387972/
https://www.ncbi.nlm.nih.gov/pubmed/35984146
http://dx.doi.org/10.1097/MD.0000000000030137
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author Kim, Ji Hyun
Kim, Sora
Yu, Taeyoung
Yang, Woo Seok
Hong, Seong Wook
author_facet Kim, Ji Hyun
Kim, Sora
Yu, Taeyoung
Yang, Woo Seok
Hong, Seong Wook
author_sort Kim, Ji Hyun
collection PubMed
description RATIONALE: The prone position is the most commonly required position during spinal surgery. Decreasing lumbar lordosis is necessary to facilitate the accessibility of the surgical field. And this can affect the hemodynamic circulation of the patients. The Jackson spine table is one of the most preferred methods, known to have minimal effects on cardiac function. PATIENT CONCERNS: We report a case of sudden arrhythmia that developed during the prone position using a Jackson spine table. It occurred 30 minutes after the positional change. DIAGNOSES: Arrhythmia showed bizarre P and QRS waves. Ectopic P, bundle branch block, or both was suspected. INTERVENTIONS: Because it was difficult to define the exact type or cause of this sudden arrhythmia and considering that other vital signs remained stable, we decided to keep close observation during the operation rather than applying uncertain antiarrhythmic medication. OUTCOMES: Arrhythmia spontaneously developed and subsided repeatedly. And it recovered to normal sinus rhythm immediately after the positional change to the supine position. Therefore, increased intrathoracic pressure caused by the prone position was highly suspected to be the cause of this event. LESSONS: Although the Jackson spine table is known to have the least effect on cardiac function, the patient experienced arrhythmia in our case. Hence, to achieve better clinical outcomes, an understanding of physiological alterations and possible complications caused by the prone position is necessary for earlier diagnosis and management.
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spelling pubmed-93879722022-08-23 Sudden arrhythmia in the prone position during spinal surgery: A case report Kim, Ji Hyun Kim, Sora Yu, Taeyoung Yang, Woo Seok Hong, Seong Wook Medicine (Baltimore) Research Article RATIONALE: The prone position is the most commonly required position during spinal surgery. Decreasing lumbar lordosis is necessary to facilitate the accessibility of the surgical field. And this can affect the hemodynamic circulation of the patients. The Jackson spine table is one of the most preferred methods, known to have minimal effects on cardiac function. PATIENT CONCERNS: We report a case of sudden arrhythmia that developed during the prone position using a Jackson spine table. It occurred 30 minutes after the positional change. DIAGNOSES: Arrhythmia showed bizarre P and QRS waves. Ectopic P, bundle branch block, or both was suspected. INTERVENTIONS: Because it was difficult to define the exact type or cause of this sudden arrhythmia and considering that other vital signs remained stable, we decided to keep close observation during the operation rather than applying uncertain antiarrhythmic medication. OUTCOMES: Arrhythmia spontaneously developed and subsided repeatedly. And it recovered to normal sinus rhythm immediately after the positional change to the supine position. Therefore, increased intrathoracic pressure caused by the prone position was highly suspected to be the cause of this event. LESSONS: Although the Jackson spine table is known to have the least effect on cardiac function, the patient experienced arrhythmia in our case. Hence, to achieve better clinical outcomes, an understanding of physiological alterations and possible complications caused by the prone position is necessary for earlier diagnosis and management. Lippincott Williams & Wilkins 2022-08-19 /pmc/articles/PMC9387972/ /pubmed/35984146 http://dx.doi.org/10.1097/MD.0000000000030137 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Kim, Ji Hyun
Kim, Sora
Yu, Taeyoung
Yang, Woo Seok
Hong, Seong Wook
Sudden arrhythmia in the prone position during spinal surgery: A case report
title Sudden arrhythmia in the prone position during spinal surgery: A case report
title_full Sudden arrhythmia in the prone position during spinal surgery: A case report
title_fullStr Sudden arrhythmia in the prone position during spinal surgery: A case report
title_full_unstemmed Sudden arrhythmia in the prone position during spinal surgery: A case report
title_short Sudden arrhythmia in the prone position during spinal surgery: A case report
title_sort sudden arrhythmia in the prone position during spinal surgery: a case report
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9387972/
https://www.ncbi.nlm.nih.gov/pubmed/35984146
http://dx.doi.org/10.1097/MD.0000000000030137
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