Severe hypotension and hepatic dysfunction in a patient undergoing scoliosis surgery in the prone position.
Many patients with neuromuscular disorders develop progressive scoliosis and require corrective surgery. We present a patient with hereditary motor and sensory neuropathies who developed severe hypotension during corrective surgery for thoracolumbar scoliosis. The haemodynamic disturbance was probably secondary to thoracic hyperlordosis and the knee-chest position and was aggravated by surgical manipulation. This may be prevented by tailored preoperative evaluation of different patient prone position supports and frames in order to select that which causes least cardiovascular and respiratory disturbance. This patient also developed severely deranged liver function postoperatively and the possible aetiology is discussed.
Department of Anaesthesiology, Queen Mary Hospital, Pokfulam, Hong Kong.
V M Y
VM
Yuen
B F M
BF
Chow
M G
MG
Irwin
D000328:Adult; D015417:Hereditary Sensory and Motor Neuropathy / Q000150:complications; D006801:Humans; D007022:Hypotension / Q000209:etiology*; D007511:Ischemia / Q000209:etiology; D008107:Liver Diseases / Q000201:enzymology / Q000209:etiology*; D008141:Lordosis / Q000000981:diagnostic imaging; D008297:Male; D011183:Postoperative Complications; D016684:Prone Position; D011859:Radiography; D012600:Scoliosis / Q000150:complications / Q000601:surgery*