Post-endoscopy subarachnoid hypertension syndrome: a case series in the recovery period after unilateral biportal endoscopic surgery under general anesthesia.

PURPOSE: To describe the clinical features, perioperative management, and outcomes of post-endoscopy subarachnoid hypertension syndrome (PESHS) in patients recovering from unilateral biportal endoscopic (UBE) spinal surgery under general anesthesia.

METHODS

This retrospective case series reviewed three consecutive patients who developed PESHS in the post-anesthesia care unit (PACU) following UBE procedures under general anesthesia at a single center.

RESULTS

The three patients presented with acute severe hypertension, tachycardia, altered consciousness, and increased muscle tone. Management included dehydration, sedation with propofol plus dexmedetomidine, analgesia, and anti-inflammatory therapy. Clinical improvement occurred within 2-5 h; all patients were discharged without sequelae.

CONCLUSION

PESHS after UBE is manageable with early recognition and a structured approach combining vigilant monitoring, targeted interventions, and meticulous nursing care.