Posterior Lumbar Fusion with Prolonged QT

A 70-year-old man presents on the day of surgery for an elective L2-L5 posterior lumbar intervertebral fusion (PLIF), with a plan for intraoperative neurophysiological monitoring. Medical History Back pain Hypertension Type 2 diabetes mellitus Paroxysmal atrial fibrillation Smoker Medications Sotalol 80 mg twice daily Enalapril 10 mg twice daily Metformin 500 mg twice daily Paracetamol 667 mg three times daily Meloxicam 15 mg daily Gabapentin 600 mg three times daily Tramadol 100 mg three times daily PRN Vital Statistics Height 1.80 m Weight 101 kg Body Mass Index (BMI) 31 kg/m2 Preoperative blood test results are included below. An electrocardiogram (ECG) was performed this morning on admission to hospital and is attached. Full blood count test results: Haemoglobin 148 g/L (115-160) White cell count 5.2 x10^9/L (4.0-11.0) Platelet count 398 x10^9/L (150-400) Biochemistry test results: Sodium 138 mmol/L (135-145) Potassium 4.2 mmol/L (3.5-5.2) Bicarbonate 26 mmol/L (22-32) Urea 6.1 mmol/L (3.0-8.0) Creatinine 89 µmol/L (45-90) eGFR 69 mL/min/m2 (>80)