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Case 44 - Majorvascular complication during spine surgery

from Section I - Neuroanesthesia

Published online by Cambridge University Press:  03 May 2011

By
Zeyd Ebrahim  and
Jia Lin
Edited by
George A. Mashour  and
Ehab Farag
George A. Mashour
Affiliation:
University of Michigan
Ehab Farag
Affiliation:
Cleveland Clinic
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Summary

Anesthesia for complex spine surgery requires invasive monitoring, large-bore intravenous access, and awareness of the potential for disaster. Anesthesiologists involved in the care of patients undergoing complicated spine surgery should be cognitive of this infrequent but serious complication. This chapter presents a case study of a 75-year-old female who was scheduled for removal of instrumentation at L4-S1 and re-exploration of a previous posterior lumbar inter-body fusion. The intraoperative course was also complicated by significant coagulopathy from massive blood loss and transfusion. The postoperative course was complicated by nonoliguric renal failure, pneumonia, and urinary tract infection. The role of central venous monitoring is always debated in the context of major spine surgery. However, central venous pressure readings in the prone position may not reflect accurate data and large bore intravascular access and invasive blood pressure monitoring are probably more important in the hemodynamic management of these cases.

Keywords

Parkinson's diseasepostoperative managementsubthalamic nucleusneurologic changesdeep brain stimulationlevodopa
Type
Chapter
Information
Case Studies in Neuroanesthesia and Neurocritical Care , pp. 143 - 145
Publisher: Cambridge University Press
Print publication year: 2011

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