[Preoperative prophylactic pacemakers: apropos of their indication in a disputed case].
The criteria for preoperative use of pacemakers are not unanimously agreed upon. Certain cases require careful assessment to weigh potential benefits against inherent risks in placing the device. Although external transcutaneous pacemakers, whose use circumvents the risks of transvenous insertion, have been available for years, such devices are not always appropriate, depending on the flow disorder involved or the type of surgery that will be performed. We report the case of a 75-year-old woman who was a candidate for surgery requiring general anesthesia (lumboperitoneal shunt due to chronic adult hydrocephaly). Although her condition did not initially call for prophylactic use of a pacemaker before surgery, changes soon developed that necessitated insertion of a temporary transvenous device for surgery and insertion of a permanent pacemaker the day after surgery.
Fuentes Rodríguez
R
R
Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Universitario Puerta del Mar, Cádiz. rosariofuentes@comcadiz.es
Sebastianes Marfil
M C
MC
Mato Ponce
M
M
Morales Guerrero
J
J
Torres Morera
L M
LM
D000368:Aged; D000768:Anesthesia, General; D002037:Bundle-Branch Block / Q000150:complications / Q000628:therapy*; D002304:Cardiac Pacing, Artificial / Q000379:methods; D002544:Cerebral Infarction / Q000150:complications; D002557:Cerebrospinal Fluid Shunts; D000075202:Contraindications; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006973:Hypertension / Q000150:complications; D017379:Hypertrophy, Left Ventricular / Q000150:complications; D007431:Intraoperative Complications / Q000517:prevention & control / Q000628:therapy*; D010138:Pacemaker, Artificial; D011183:Postoperative Complications / Q000628:therapy; D011300:Preoperative Care / Q000379:methods*; D013575:Syncope / Q000209:etiology