Chin necrosis after prone positioning: A consequence of trans-cranial motor evoked potential monitoring during spine surgery

Sir, A 40-year-old male patient, belonging to American Society of Anesthesiologists (ASA) physical status class I, diagnosed with D5–D7 spinal cord astrocytoma, was posted for laminectomy and excision of the lesion. On the day of surgery, after attaching standard monitors including pulse oximetry, e...

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Bibliographic Details
Published in:Indian journal of anaesthesia 2019-03, Vol.63 (3), p.246-248
Main Authors: Gupta, Priyanka, Barik, Amiya, Krishna, Vamshi, Dhar, Mridul
Format: Article
Language:English
Subjects:
Anesthesia
Letters to Editor
Pressure distribution
Surgery
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Summary:Sir, A 40-year-old male patient, belonging to American Society of Anesthesiologists (ASA) physical status class I, diagnosed with D5–D7 spinal cord astrocytoma, was posted for laminectomy and excision of the lesion. On the day of surgery, after attaching standard monitors including pulse oximetry, electrocardiography, non-invasive blood pressure and capnography, general anaesthesia was induced with fentanyl 1.5 μg/kg intravenous (IV), propofol 2 mg/kg IV, and vecuronium 0.1 mg/kg IV, and the trachea was intubated with an 8.0-mm oral reinforced tube, and anaesthesia was maintained with oxygen, air, and sevoflurane. Some of the preventive measures to avoid such complications include use of a transparent operating table with a foam-cushion face mask, careful selection of an appropriate head rest, a polyurethane foam head rest within a protected helmet system, identification of high-risk patients, careful selection of appropriate support devices and regular monitoring for signs of pressure injuries incorporating frequent turning.
ISSN:0019-5049
0976-2817
DOI:10.4103/ija.IJA_759_18