Published online Aug 26, 2023. doi: 10.12998/wjcc.v11.i24.5789
Peer-review started: May 24, 2023
First decision: July 3, 2023
Revised: July 7, 2023
Accepted: August 2, 2023
Article in press: August 2, 2023
Published online: August 26, 2023
Atrial arrhythmias such as paroxysmal supraventricular tachycardia (PSVT) and atrial flutter (AF) are common in the perioperative setting. They commonly resolve spontaneously. However, occasionally, they may continually progress to fatal arrhythmias or cause complications. Therefore, prompt and appropriate management is important.
A 46-year-old female patient diagnosed with cervical C6-7 radiculopathy characterized by decreased sensation in the right third, fourth and fifth fingers underwent C6-7 anterior cervical disc fusion surgery. Electrocardiography showed PSVT and ventricular tachycardia during C6-7 disc retraction. However, the patient remained stable. Initial treatment with esmolol and lidocaine for ventricular tachycardia was ineffective. Carotid massage and Valsalva maneuver were attempted but PSVT did not resolve. The surgery was paused, and the patient’s fraction of inspired oxygen was set to 100%. Adenosine was admini
Ganglia associated with cardiac arrhythmias in the surgical site should be iden
Core Tip: Paroxysmal supraventricular tachycardia and atrial flutter can occur without structural heart disease and are present at any age. In the current case, the arrhythmia was caused by the surgical stimulation of the stellate ganglion in a patient without a significant medical history. Electrocardiography results were similar, making it difficult to identify the type of arrhythmia. Hence, another arrhythmia was observed even after appropriate treatment. In such a case, if an arrhythmia occurs in the context of stimulation of the right stellate ganglion during cervical spine surgery, identification of triggers to consider, correction of the appropriate triggers, and prevention of migration to fatal arrhythmias should be considered.