Transient left bundle branch block after posture change to the prone position during general anesthesia A case report

被引:3
|
作者
Ko, Hyun-Cheol [1 ]
Cho, Yong-Hyun [1 ]
Jang, Won [1 ]
Kim, Sun-Hee [1 ]
Lee, Hyun-Seok [1 ]
Ko, Woo-Hyeong [1 ]
机构
[1] Seoul Sacred Heart Gen Hosp, Dept Anesthesiol & Pain Med, 259 Wangsan Ro, Seoul 02488, South Korea
关键词
hemodynamic changes; left bundle branch block; prone position;
D O I
10.1097/MD.0000000000025190
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Rationale: The prone position is commonly used in spinal surgery. There have been many studies on hemodynamic changes in the prone position during general anesthesia. We report a rare case of transient left bundle branch block (LBBB) in a prone position. Patient concern: Electrocardiogram (ECG) of a 64-year-old man scheduled for spinal surgery showed normal sinus rhythm change to LBBB after posture change to the prone position. Diagnosis: Twelve lead ECG revealed LBBB. His coronary angio-computed tomography results showed right coronary artery with 30% to 40% stenosis and left circumflex artery with 40% to 50% stenosis. The patient was diagnosed with stable angina and second-degree atrioventricular block of Mobitz type II. Intervention: Nitroglycerin was administered intravenously during surgery. Adequate oxygen was supplied to the patient. After surgery, the patient was prescribed clopidogrel, statins, angiotensin II receptor blocker, and a permanent pacemaker was inserted. Outcome: Surgery was completed without complications. After surgery, the transient LBBB changed to a normal sinus rhythm. The patient did not complain of chest pain or dyspnea. Lesson: The prone position causes significant hemodynamic changes. A high risk of cardiovascular disease may cause ischemic heart disease and ECG changes. Therefore, careful management is necessary.
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页数:4
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