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Korean J Anesthesiol > Volume 57(6); 2009 > Article
Korean Journal of Anesthesiology 2009;57(6):768-772.
DOI: https://doi.org/10.4097/kjae.2009.57.6.768   
Cardiac arrest in the prone position with the Andrews frame during lumbar spine surgery: A case report.
Jae Young Kim, Eun Joo Kim, Ji Hyang Lee, Sang Kon Lee, Jong Suk Ban, Byung Woo Min
Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea. kej1127@fatima.or.kr
Abstract
The prone position during anesthesia sometimes causes hemodynamic changes such as a decrease in blood pressure. These changes are caused by a decrease in venous return from venous pooling in the legs, and decreased left ventricular compliance secondary to increased intrathoracic pressure, when patients are placed prone with an Andrews frame. We report on a patient who experienced cardiac arrest in the prone position with the Andrews frame during lumbar laminectomy and posterior lumbar interbody fusion. After 1.25 h in the prone position, bradycardia and hypotension occurred. Ephedrine, atropine and epinephrine were infused intravenously, but bradycardia and hypotension progressed to asystole. Cardioinhibitory reflex was likely triggered by decreased venous return and increased intrathoracic pressure, and the patient developed cardiac arrest as a result.
Key Words: Andrews frame; Cardiac arrest; Lumbar laminectomy; Posterior lumbar interbody fusion; Prone position
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