{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:06:35Z","timestamp":1756339595829,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,4,7]]},"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>Patients with uncorrected cyanotic congenital heart disease undergoing non-cardiac surgery could be challenging to the anaesthesiologist as these patients are at a high risk for perioperative complications, including hypercyanotic spells. This case report describes the successful anaesthetic management of a paediatric patient with uncorrected tetralogy of Fallot who underwent emergency evacuation of intracranial abscess in the prone position under general anaesthesia. The intraoperative course was complicated by recurrent hypercyanotic spells. This report focuses on the unique considerations, recognition of hypercyanotic spells, its pathophysiology, precipitating factors and corresponding management.<\/jats:p>","DOI":"10.1136\/bcr-2025-265180","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T23:35:27Z","timestamp":1744932927000},"page":"e265180","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Intraoperative hypercyanotic spells in a paediatric patient with uncorrected tetralogy of Fallot undergoing drainage of intracranial abscess in the prone position"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1767-7976","authenticated-orcid":false,"given":"Ginalyn Jacinto","family":"De Guzman","sequence":"first","affiliation":[{"name":"University of the Philippines-Philippine General Hospital Department of Anesthesiology, Manila, NCR, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7313-0008","authenticated-orcid":false,"given":"Geraldine Raphaela","family":"Jose","sequence":"additional","affiliation":[{"name":"University of the Philippines-Philippine General Hospital Department of Anesthesiology, Manila, NCR, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,4,17]]},"reference":[{"key":"2025082712131972000_18.4.e265180.1","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.bjae.2019.07.003","article-title":"Tetralogy of Fallot","volume":"19","author":"Wilson","year":"2019","journal-title":"BJA Educ"},{"key":"2025082712131972000_18.4.e265180.2","doi-asserted-by":"crossref","unstructured":"Ahmed T , Sanil Y , Heidemann SM , et al . Hypercyanotic spells. In: Sarnaik A , Ross R , Lipshultz S , eds. Cardiac emergencies in children. Springer, 2018.","DOI":"10.1007\/978-3-319-73754-6_9"},{"key":"2025082712131972000_18.4.e265180.3","doi-asserted-by":"crossref","DOI":"10.1016\/j.heliyon.2023.e22198","article-title":"Incidence, clinical profile and short term outcome of cerebral abscess in cyanotic congenital heart diseases","volume":"9","author":"Sangi","year":"2023","journal-title":"Heliyon"},{"key":"2025082712131972000_18.4.e265180.4","doi-asserted-by":"crossref","DOI":"10.1016\/j.idcr.2020.e00954","article-title":"Brain abscess: A rare complication in a child with tetralogy of Fallot","volume":"22","author":"Lakhani","year":"2020","journal-title":"IDCases"},{"key":"2025082712131972000_18.4.e265180.5","unstructured":"Gossett J , Kamp A . Tetralogy of fallot december. 2018. Available: https:\/\/bestpractice.bmj.com\/topics\/en-gb\/701"},{"key":"2025082712131972000_18.4.e265180.6","article-title":"Perioperative Management of Emergency Craniotomes in Children With Cyanotic Congenital Heart Disease: A Case Series","volume":"15","author":"Dey","year":"2023","journal-title":"Cureus"},{"key":"2025082712131972000_18.4.e265180.7","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-017-2375-6"},{"key":"2025082712131972000_18.4.e265180.8","doi-asserted-by":"publisher","DOI":"10.4103\/0259-1162.143110"},{"key":"2025082712131972000_18.4.e265180.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0952-8180(97)00216-X"},{"key":"2025082712131972000_18.4.e265180.10","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aem380"},{"key":"2025082712131972000_18.4.e265180.11","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1097\/01.brs.0000218485.96713.44","article-title":"Effect of Prone Positioning Systems on Hemodynamic and Cardiac Function During Lumbar Spine Surgery: An Echocardiographic Study","volume":"31","author":"Dharmavaram","year":"2006","journal-title":"Spine (Phila Pa 1986)"},{"key":"2025082712131972000_18.4.e265180.12","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(53)90083-7"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-265180","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:13:28Z","timestamp":1756322008000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-265180"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":12,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4,17]]},"published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1136\/bcr-2025-265180"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-265180","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,4]]}}}