Severe Anxiety-Induced Respiratory Alkalosis During Repeat Percutaneous Endoscopic Lumbar Discectomy: A Case Report

A 44-year-old male with recurrent lumbar disc herniation developed severe anxiety-induced respiratory alkalosis during repeat percutaneous endoscopic lumbar discectomy (PELD) under monitored anesthesia care (MAC). Despite using dexmedetomidine and propofol for sedation, the patient exhibited extreme agitation, necessitating increased anesthetic dosages and subsequent management of metabolic disturbances in the post-anesthesia care unit (PACU). This case underscores the challenges of managing anxiety in minimally invasive spinal surgeries and emphasizes the need for individualized perioperative strategies to prevent complications. The patient recovered fully with appropriate medical intervention and supportive care.