Published online Sep 6, 2022. doi: 10.12998/wjcc.v10.i25.9050
Peer-review started: March 29, 2022
First decision: May 30, 2022
Revised: June 7, 2022
Accepted: August 1, 2022
Article in press: August 1, 2022
Published online: September 6, 2022
Processing time: 150 Days and 23.5 Hours
Intradural anesthesia caused by anesthetic drug leakage during percutaneous vertebroplasty (PVP) has rarely been reported. We here report a 71-year-old woman who suffered this rare and life-threatening complication during PVP.
A 71-year-old woman, who suffered from 2 wk of severe back pain with a visual analog score of 8, came to our outpatient clinic. She was later diagnosed with a newly compressed L1 fracture and was then admitted in our department. PVP was initially attempted again under local anesthesia. However, serendipitous intradural anesthesia leading to total spinal anesthesia happened. Fortunately, after successful resuscitation of the patient, PVP was safely and smoothly performed. Great pain relief was achieved postoperatively, and she was safely discharged on postoperative day 4. The patient recovered normally at 3-mo follow-up.
Total spinal anesthesia secondary to PVP by anesthetic drug leakage rarely occurs. In cases of inadvertent wrong puncture leading to drug leakage when performing it under local anesthesia, surgeons should be highly vigilant during the whole procedure. Electrocardiogram monitoring, oxygen inhalation, intravenous cannula set prior to surgery, regular checking of motor activity and a meticulous imaging monitoring with slower pushing of anesthetic drugs, etc. should be highly recommended.
Core Tip: Total spinal anesthesia secondary to percutaneous vertebroplasty (PVP) rarely occurs. In our case, we encountered this phenomenon when performing PVP under local anesthesia. Fortunately, with our prompt interventions, the patient received a satisfactory outcome. From our experience, it is fundamentally important that electrocardiogram monitoring, oxygen inhalation, intravenous cannula set prior to surgery, regular checking of motor activity and a meticulous imaging monitoring with slower pushing of anesthetic drugs, etc. should be highly recommended.