Full flexion of the hips and knees in the supine position to treat an episode of acute hypotension and pulseless electrical activity in a patient with severe aortic stenosis

This is a case report of a 77-year-old man with severe symptomatic aortic stenosis who underwent removal of an impacted ureteral stone under general anesthesia. During emergence from general anesthesia, his legs were lowered from lithotomy position, resulting in sudden hypotension with progression t...

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Published inProceedings - Baylor University. Medical Center Vol. 35; no. 5; pp. 703 - 704
Main Authors McAllister, Russell K., Tippett, J. Clint, Culp, William C.
Format Journal Article
LanguageEnglish
Published Dallas Taylor & Francis Ltd 03.09.2022
Taylor & Francis
Subjects
Aortic stenosis
Case Report
Case Studies
General anesthesia
Hypotension
Patient positioning
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Summary:This is a case report of a 77-year-old man with severe symptomatic aortic stenosis who underwent removal of an impacted ureteral stone under general anesthesia. During emergence from general anesthesia, his legs were lowered from lithotomy position, resulting in sudden hypotension with progression to pulseless electrical activity. The legs were raised and placed into full flexion of the hips and knees. This maneuver was temporally related to a return of spontaneous circulation and full recovery. Possible mechanisms for this effect are discussed.
Bibliography:The authors report no funding or conflicts of interest. Patient and family permission to publish this case report was granted.
ISSN:0899-8280
1525-3252
DOI:10.1080/08998280.2022.2075663