頸椎手術時低體溫引起無脈搏電氣活動之病例報告

Inadvertent Hypothermia Causes Pulseless Electrical Activity in a Patient during Cervical Spine Surgery-- A Case Report

最近報告認為低體溫可增加心臟併發症的發生率。本病例報告一位71歲男性，於接受頸椎骨板去除手術採坐姿時，發生無脈搏電氣活動。藉由經食道心臟超音波及心肌酶測定的幫助，排除靜脈空氣栓塞、血栓塞或急性心肌梗塞的可能。手術中除體溫低至31°C外，其他沒有異常的發現。因此我們認為低體溫是造成此病患發生無脈搏電氣活動的主要原因。

Recent studies have shown that hypothermia triples the incidence of major cardiac events. We present a happening in which a 71-year-old patient developed pulseless electrical activity (PEA) while he was undergoing cervical laminectomy for spinal stenosis in the sitting position. Thromboembolism or venous air embolism and acute myocardial infarction were respectively excluded by transesophageal echocardiography and cardiac enzymes analysis to be the causes of the cardiac event. The abnormal finding that stood out was low nasopharyngeal temperature (31°C) during the procedure, which was thought to contribute to the development of the PEA episode.