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Vol. 30. Issue 1.
Pages 1-52 (January - February 2019)
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Vol. 30. Issue 1.
Pages 1-52 (January - February 2019)
Case Report
DOI: 10.1016/j.neucir.2018.08.004
Severe hypertension and tachycardia during transforaminal endoscopic discectomy – Is indigocarmine to blame?
Hipertensión severa y taquicardia durante la discectomía endoscópica transforaminal: ¿se puede culpar a la indigocarmina?
Baturay Kansu Kazbeka,
Corresponding author

Corresponding author.
, Hakan Yılmaza, Burak Kazancıb, Perihan Ekmekçia, Hakan Sabuncuoğlub
a Ufuk University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Turkey
b Ufuk University, Faculty of Medicine, Department of Neurosurgery, Turkey
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Endoscopic transforaminal discectomy is a minimally invasive technique used for the surgical treatment of herniated discs. Indigocarmine is a dye which is widely used to identify the ureteral orifice in urologic procedures. Hemodynamic effects such as hypotension and anaphylaxis in addition to hypertension, bradycardia and atrioventricular block have been reported in intravenous application of indigocarmine. The aim of this case report is to prepare anesthesiologists for such cases and make them consider invasive blood pressure monitorization. Both patients had radicular pain radiating to the leg and scheduled to undergo transforaminal endoscopic discectomy. Intraoperative vital signs were within normal limits, however severe hypertension and tachyarrhythmia developed following the injection. Hemodynamics in both patients returned to normal following lidocaine and nitroglycerine injection.

Transforaminal endoscopic discectomy

La discectomía endoscópica transforaminal es una técnica mínimamente invasiva utilizada para el tratamiento quirúrgico de discos herniados. Indigocarmine es un tinte que se usa ampliamente para identificar el orificio ureteral en procedimientos urológicos. Se han informado efectos hemodinámicos como hipotensión y anafilaxia además de hipertensión, bradicardia y bloqueo auriculoventricular en la aplicación intravenosa de indigocarmina. El objetivo de este informe de caso es preparar a los anestesiólogos para tales casos y hacer que consideren la monitorización invasiva de la presión sanguínea. Ambos pacientes tenían dolor radicular que irradiaba a la pierna y se programaron para recibir una discectomía endoscópica transforaminal. Los signos vitales intraoperatorios se encontraron dentro de los límites normales, sin embargo, la hipertensión severa y la taquiarritmia se desarrollaron después de la inyección. La hemodinámica en ambos pacientes volvió a la normalidad después de la inyección de lidocaína y nitroglicerina.

Palabras clave:
Discectomía endoscópica transforaminal


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