The overhead lights suddenly flickered, and all the individuals in the operating room sensed a noticeable surge of power. The procedure was progressing smoothly until the third hour of this scheduled 8-hour case. General anesthesia was maintained with nitrous oxide and oxygen, isoflurane, and vecuronium, as well as a supplemental infusion of remifentanil. Next, we induced the patient with intravenous medications and nasally intubated her without complications. We included deliberate hypotension in the anesthetic plan to minimize intraoperative blood loss.
We placed 2 peripheral intravenous lines and inserted a radial arterial line to closely monitor blood pressure. The planned procedure was a Lefort 1 osteotomy, bilateral mandibular osteotomies, and a genioplasty. This report will recount the immediate response to this unexpected incident and propose several recommendations for the preparation and management of any similar future occurrences.Ī 23-year-old healthy woman entered the operating room to undergo a complex oral and maxillofacial surgery to correct a dentofacial deformity. In the operating room, safely administering anesthesia amidst a major power failure instantly presented a formidable challenge. The impact of the power loss was omnipresent. This report's account of events is aimed to “shed some light” on this topic, serve as a check of one's own preparedness, and facilitate the optimal management of a similarly unexpected incident.ĭuring a hot midsummer's day in 2003, an estimated 50 million inhabitants of New York City, multiple surrounding states, and parts of Canada experienced one of the largest blackouts in history. Various recommendations are proposed with respect to the preparation for and the prevention of a power failure in the operating room. The importance of one's familiarity with an anesthesia machine's backup battery supply, routinely checking machinery, ensuring that appropriate and sufficient supplies are readily available, exercising calm leadership with clear communication, and formulating a clear plan with backup alternatives are discussed. Providing adequate oxygenation, ventilation, anesthesia levels, monitoring of vital signs, and transportation of the patient were some of the challenges faced, and the response to this unexpected event is recounted. Three hours into the case and with the patient's maxilla downfractured, the overhead surgical lights blacked out, and there was an apparent loss of the anesthesia machine's ability to function. A case is presented involving a 23-year-old healthy woman who underwent a complex oral and maxillofacial surgery to correct a dentofacial deformity. In the operating room, safely administering anesthesia amidst a major power failure can instantly present one with a formidable challenge.
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