Key result
The patient with a temporary pacemaker remained hemodynamically stable without complications during a 3-hour craniotomy in the prone position.
Why the study?
Patients with pacemakers increasingly require non-cardiac surgery, necessitating appropriate perioperative management to optimize outcomes and avoid morbidity and mortality.
Case Report (n=1)
Careful perioperative management, including avoidance of electromagnetic interference and careful positioning, allows for safe non-cardiac surgery in the prone position for patients with temporary pacemakers.
Case report of stable prone surgery with temporary pacemaker is hypothesis-generating; prospective studies needed before broader adoption.
Introduction: As the incidence of the need for a pacemaker increases, an anesthesiologist may encounter patients with pacemakers who need surgery other than the heart. With enough knowledge, the outcome of patients with pacemakers undergoing procedures other than cardiac surgery can be optimized with the hope that mortality and morbidity can be avoided. Case presentation: Male, 42 years old, with Temporary Pacemaker (TPM), programmed for evacuation craniotomy and decompression. The patient had Intracranial Hemorrhage (ICH) after the Percutaneous Intra Arterial Thrombolysis (PIAT) procedure 2 days earlier. The patient was stable during the operation, which lasted for 3 hours in the prone position. Conclusion: The perioperative strategy should be customized based on the procedure, the needs and values of the patient, and the device attached. The primary focus of perioperative management in patients who underwent surgery is minimizing the possibility of electromagnetic interference (EMI).
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Purwoko et al. (2022) conducted a case report in Intracranial Hemorrhage with Temporary Pacemaker (n=1). Perioperative management for craniotomy in prone position was evaluated on Patient stability and perioperative complications. The patient with a temporary pacemaker remained hemodynamically stable without complications during a 3-hour craniotomy in the prone position.
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