Wang YF, Bian ZY, Li XX, Hu YX, Jiang L. Total spinal anesthesia caused by lidocaine during unilateral percutaneous vertebroplasty performed under local anesthesia: A case report. World J Clin Cases 2022; 10(25): 9050-9056 [PMID: 36157664 DOI: 10.12998/wjcc.v10.i25.9050]
Corresponding Author of This Article
Lin Jiang, PhD, Chief Anesthsiologist, Department of Anesthesiology, Taizhou People’s Hospital, No.366 Taihu Road, Hailing District, Taizhou 225300, Jiangsu Province, China. 459883821@qq.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 6, 2022; 10(25): 9050-9056 Published online Sep 6, 2022. doi: 10.12998/wjcc.v10.i25.9050
Total spinal anesthesia caused by lidocaine during unilateral percutaneous vertebroplasty performed under local anesthesia: A case report
Yu-Fei Wang, Zhao-Yue Bian, Xin-Xian Li, Yun-Xiang Hu, Lin Jiang
Yu-Fei Wang, Zhao-Yue Bian, Lin Jiang, Department of Anesthesiology, Taizhou People’s Hospital, Taizhou 225300, Jiangsu Province, China
Xin-Xian Li, Department of Spine Surgery, The People’s Hospital of Liuyang City, Liuyang 410300, Hunan Province, China
Yun-Xiang Hu, Department of Orthopedics, Dalian Municipal Central Hospital Affiliated of Dalian Medical University, Dalian 116021, Liaoning Province, China
Yun-Xiang Hu, School of Graduates, Dalian Medical University, West Section, No.8 South Lvshun Road, Lvshun District, Dalian 116000, Liaoning Province, China
Author contributions: Jiang L and Hu YX contributed to study conception and design; Wang YF, Bian ZY and Li XX collected, analyzed clinical data and wrote the manuscript; Wang YF, Bian ZY and Li XX contributed equally and are defined as co-first authors; All authors read and approved the final version of manuscript.
Informed consent statement: A written informed consent was obtained from the patient for publication of this case report.
Conflict-of-interest statement: The authors have nothing to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lin Jiang, PhD, Chief Anesthsiologist, Department of Anesthesiology, Taizhou People’s Hospital, No.366 Taihu Road, Hailing District, Taizhou 225300, Jiangsu Province, China. 459883821@qq.com
Received: March 28, 2022 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
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
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.
