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Acta Anaesthesiol Taiwan · Sep 2005
Case ReportsClipping of the appendix induced cardiac arrest during appendectomy under spinal anesthesia.
- Ya-Ching Ke, Haun-De Yi, Chih-Ping Yang, Hsien-Kuang Lee, Chang-Po Kuo, and Chih-Shung Wong.
- Division of Anesthesia, Armed Forces Taoyuan General Hospital, Taoyuan, Taiwan, ROC.
- Acta Anaesthesiol Taiwan. 2005 Sep 1; 43 (3): 183-6.
AbstractBradycardia is commonly seen in high spinal anesthesia, however, evolution of cardiac arrest from sudden onset of severe bradycardia is infrequent. Prompt recognization and resuscitative measures are of paramount importance because they may insure a complete recovery without sequela as an aftermath. We report herein a case of severe sinus bradycardia induced by clipping of the appendix during appendectomy under spinal anesthesia with the sensory block up to T5 dermatome. Prompt intravenous atropine failed to regain normal sinus rhythm, and cardiac arrest ensued. Cardiac massage, manual ventilation with oxygen and low-dose epinephrine successfully resuscitated the patient. The possible mechanisms and management of this complication are also discussed.
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