An Emergent Intraoperative Intervention: Central Venous Catheterization in a Prone Patient during Spinal Surgery

Abstract

Central venous catheterization is a critical procedure for patients undergoing major surgeries, particularly when peripheral venous access is compromised. This case report delineates the emergency placement of a central venous catheter (CVC) through the right internal jugular vein in a 63-year-old female patient positioned prone during spinal surgery. The necessity arose following significant intraoperative blood loss and the failure of peripheral venous access, presenting unique challenges due to the patient's position and the absence of sonographic guidance. The procedure was successfully executed by anatomically identifying the insertion site and utilizing a posterior lateral approach, which underscores the feasibility and urgent need for CVC placement in atypical scenarios. The patient demonstrated significant improvement with stable postoperative outcomes, emphasizing the importance of adaptability in clinical practices. This case contributes to the limited but growing body of literature on prone position CVC insertion, highlighting its viability in emergencies, despite inherent risks and technical difficulties. The findings advocate for further research and development of guidelines to enhance patient safety and procedural success in complex clinical settings.