ArticleNorth American Spine Society journal2020
Hemodynamically significant cardiac arrhythmias during general anesthesia for spine surgery: A case series and literature review.
Article in North American Spine Society journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 4 citations in OpenAlex.
- Intraoperative bradycardia leading to cardiac arrest during anterior lumbar interbody fusion (ALIF) in a morbidly obese patient-a rare complication and management strategy: a case report.Journal of spine surgery (Hong Kong) · 2025Article
- Cardiac arrest during peri-anesthetic systemic induction and maintenance in valvular heart disease: proceed or abandon? Clinical validation of a modified cardiopulmonary bypass strategy in 21 patients.European journal of medical research · 2025Article
- Suspected Somatosensory Evoked Potentials Pacing Atria During Cerebral Bypass Surgery: A Case Report.Case reports in anesthesiology · 2025Article
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Authors and funding
8 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
background contextHemodynamically significant bradycardia and cardiac arrest (CA) are rare under general anesthesia (GA) for spine surgery. Although patient risks are well defined, emerging data implicate surgical, anesthetic and neurologic factors which should be considered in the immediate management and decision to continue or terminate surgery. PURPOSE: To characterize causes and contributors to significant arrhythmias during spine surgery. We also provide an updated literature review to inform spine care teams and aid in the management of intraoperative bradycardia and CA. STUDY
designCase series and literature review. PATIENT SAMPLE: Six patients who underwent spine surgery from 03/2016 to 01/2020 at a single institution and developed unexpected hemodynamically significant arrhythmia. OUTCOME MEASURES: Our primary outcome was to identify potential risk factors of interest for significant arrhythmia during spine surgery.
methodsMedical records of patients who underwent spine surgery from 03/2016 to 01/2020 at a single institution and developed unexpected hemodynamically significant arrhythmia during spine surgery were identified from a departmental Quality Assurance Database. We evaluated the presence/absence of patient, surgical, anesthetic and neurologic risk factors and estimated the most likely etiology of the event, immediate and subsequent management, whether surgery was postponed or continued and outcomes.
resultsWe found a temporal relationship of bradyarrhythmia and CA after somatosensory evoked potential (SSEP) stimulation in 4/6 cases and pharmacy/polypharmacy in 2/6. Surgery was completed in 4/6 patients, and terminated in 2/6 (subsequently completed in both). We found no adverse outcomes in any patients. Our literature review predominately identified case reports for guidance to support decision making. New literaure suggests peripheral nerve blocks and opioid-sparing anesthetic agents should also be considered.
conclusionsSignificant bradycardia and CA during spine surgery does not always require termination of the surgical procedure. Decision making should be undertaken in each case individually, with an updated awareness of potential causes. The study also suggests the need for large prospective studies to adequately assess incidence, risk factors and outcomes.
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