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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Anesthesiol. Jul 27, 2015; 4(2): 44-48
Published online Jul 27, 2015. doi: 10.5313/wja.v4.i2.44
Published online Jul 27, 2015. doi: 10.5313/wja.v4.i2.44
Bradycardia and hypotension during pediatric scoliosis surgery-hypovolemia or spinal shock?
Cengiz Karsli, Olivia Finnerty, Department of Anesthesiology and Pain Medicine, the Hospital for Sick Children, Toronto M5G 1X8, Canada
Samuel Strantzas, Laura Holmes, Division of Neurophysiology, the Hospital for Sick Children, Toronto M5G 1X8, Canada
Stephen Lewis, Department of Surgery, Division of Orthopedic Surgery, the Hospital for Sick Children, Toronto M5G 1X8, Canada
Author contributions: All authors contributed to this paper.
Institutional review board statement: Research Ethics Board approval was waived for this case report.
Informed consent statement: Written informed consent was obtained to submit this manuscript and publish the imaging details.
Conflict-of-interest statement: The authors have no conflict of interests to report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Cengiz Karsli, Department of Anesthesiology and Pain Medicine, the Hospital for Sick Children, 555 University Avenue, Toronto M5G 1X8, Canada. cengiz.karsli@sickkids.ca
Telephone: +1-416-8137445 Fax: +1-416-8137543
Received: January 20, 2015
Peer-review started: January 21, 2015
First decision: February 7, 2015
Revised: March 31, 2015
Accepted: April 27, 2015
Article in press: April 29, 2015
Published online: July 27, 2015
Peer-review started: January 21, 2015
First decision: February 7, 2015
Revised: March 31, 2015
Accepted: April 27, 2015
Article in press: April 29, 2015
Published online: July 27, 2015
Core Tip
Core tip: A child undergoing scoliosis repair developed sudden bradycardia and hypotension, associated with loss of somatosensory and motor evoked potentials to all four limbs. Spinal shock and hypovolemia were diagnosed after ruling out other causes. Acute complications of scoliosis repair are reviewed along with sympathetic nervous system anatomy. Spinal shock was likely due to hypovolemia and spinal cord manipulation during vertebral column resection that was needed to effect scoliosis correction. Treatment included volume expansion and inotropic support. Anesthesiologists should be mindful of the possibility of spinal shock during correction of severe scoliosis, particularly when vertebral column resection is undertaken.