Asystole during percutaneous ethanol injection of symptomatic vertebral haemangioma.
Computed tomography guided percutaneous ethanol injection is frequently employed for treatment of symptomatic vertebral haemangiomas. The procedure is performed under monitored anaesthesia care in the prone position. It has several advantages over open surgery and other therapeutic modalities and is generally considered safe. There is no previous report of any significant haemodynamic disturbance attributable to alcohol ablation of vertebral haemangiomas. We report a case in which a patient of ASA physical status I developed asystole following injection of 100% alcohol into a vertebral haemangioma, and became apnoeic and unresponsive. He recovered following intravenous administration of atropine. All staff involved in this procedure should be aware of and prepared for, this rare but potentially life-threatening complication.
Sharma
D
D
Department of Neuroanaesthesiology, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi.
Jain
V
V
Rath
G P
GP
D000328:Adult; D001049:Apnea / Q000139:chemically induced; D001285:Atropine / Q000627:therapeutic use; D002492:Central Nervous System Depressants / Q000009:adverse effects* / Q000627:therapeutic use; D020785:Central Nervous System Vascular Malformations / Q000150:complications* / Q000628:therapy; D004562:Electrocardiography; D000431:Ethanol / Q000009:adverse effects* / Q000627:therapeutic use; D006323:Heart Arrest / Q000209:etiology*; D006391:Hemangioma / Q000150:complications* / Q000628:therapy; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D013125:Spinal Neoplasms / Q000150:complications* / Q000628:therapy; D014057:Tomography, X-Ray Computed
D002492:Central Nervous System Depressants; D018727:Muscarinic Antagonists; D000431:Ethanol; D001285:Atropine