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.