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Cardiac arrest spinal anesthesia

Seiko Sato, Erisa Nakamori, Go Kusumoto, Kenji Shigematsu, Ken Yamaura
A 28-year-old woman with preeclampsia at 32 weeks of gestation underwent a cesarean delivery under spinal anesthesia. Administration of nitroglycerin at 200 μg to relax uterine smooth muscles and the application of fundal pressure led to severe bradycardia and loss of consciousness, followed by cardiac arrest. Delivery was completed immediately and recovery was achieved 10 seconds later following cardiopulmonary resuscitation. Neurally mediated syncope was considered the cause of cardiac arrest. Anesthetists should be aware of the potential risk during cesarean delivery following the administration of nitroglycerin, fundal pressure, regional anesthesia, and hypovolemia because of preeclampsia...
January 4, 2017: A & A Case Reports
Baek Jin Kim, Bong Il Kim, Sung Hye Byun, Eugene Kim, Shin Yeung Sung, Jin Yong Jung
BACKGROUND: Dexmedetomidine is a sedative and analgesic agent that is administered intravenously as an adjunct to spinal anesthesia. It does not suppress the respiratory system significantly, but has adverse effects on the cardiovascular system, for example, bradycardia and hypotension. We here report a patient who underwent cardiac arrest during spinal anesthesia after intravenous infusion of dexmedetomidine. METHODS: A 57-year-old woman with no significant medical history underwent spinal anesthesia for arthroscopic meniscus resection after rupturing the right knee meniscus...
October 2016: Medicine (Baltimore)
Carlos Javier Shiraishi Zapata
I report a case of hypotension and bradycardia before spinal anesthesia in a pregnant woman with mild to moderate hypertension treated with nifedipine and methyldopa, scheduled for an elective cesarean delivery. She had the history of neurally-mediated syncopes. Two main factors (increased vagal tone and adverse effects of antihypertensive drugs) could explain the hypotension and bradycardia before spinal anesthesia. Monitoring allowed recognizing the problem and corrected it. Thus, it was avoided a disaster in anesthesia, as hemodynamic changes after spinal anesthesia, they would have joined to previous hypotension and bradycardia, which would have caused even a cardiac arrest...
September 26, 2016: Revista Brasileira de Anestesiologia
Anahi Perlas, Vincent W S Chan, Scott Beattie
BACKGROUND: This propensity score-matched cohort study evaluates the effect of anesthetic technique on a 30-day mortality after total hip or knee arthroplasty. METHODS: All patients who had hip or knee arthroplasty between January 1, 2003, and December 31, 2014, were evaluated. The principal exposure was spinal versus general anesthesia. The primary outcome was 30-day mortality. Secondary outcomes were (1) perioperative myocardial infarction; (2) a composite of major adverse cardiac events that includes cardiac arrest, myocardial infarction, or newly diagnosed arrhythmia; (3) pulmonary embolism; (4) major blood loss; (5) hospital length of stay; and (6) operating room procedure time...
October 2016: Anesthesiology
Satoshi Shinohara, Ikuko Sakamoto, Masahiro Numata, Atsushi Ikegami, Katsuhiro Teramoto, Shuji Hirata
Spinal anesthesia is regularly performed worldwide and is an integral part of the modern day anesthesia practice. Although unexpected cardiac arrests during this procedure are very rare, medical professionals should be aware of the potential for this complication. In making the decision to use spinal anesthesia, judicious patient selection, adequate preventive measures, and strict monitoring are important.
May 2016: Clinical Case Reports
Frederic Shapiro, Umeshkumar Athiraman, David J Clendenin, Monica Hoagland, Navil F Sethna
BACKGROUND: The objectives are to review the anesthetic management and anesthetic-related adverse events in patients undergoing muscle biopsy for a broad spectrum of neuromuscular disorders (NMD). AIM: The study aims to assess the hypothesis that perceived awareness of potential anesthesia-induced hyperkalemia and MH in patients with NMD reduces the frequency of such events. METHODS: A 20-year retrospective review of 877 consecutive patients undergoing muscle biopsy to establish diagnoses of NMD has been performed...
July 2016: Paediatric Anaesthesia
Larissa Cardoso Pinheiro, Bruno Mendes Carmona, Mário de Nazareth Chaves Fascio, Iris Santos de Souza, Rui Antonio Aquino de Azevedo, Fabiano Timbó Barbosa
Cardiac arrest during neuraxial anesthesia is a serious adverse event, which may lead to significant neurological damage and death if not treated promptly. The associated mechanisms are neglected respiratory failure, extensive sympathetic block, local anesthetic toxicity, total spinal block, in addition to the growing awareness of the vagal predominance as a predisposing factor. In the case reported, the patient was 25 years old, ASA I, scheduled for aesthetic lipoplasty. After sedation with midazolam and fentany, epidural anesthesia in interspaces T12-L1 and T2-T3 and catheter insertion into inferior puncture were performed...
January 22, 2016: Revista Brasileira de Anestesiologia
Narasimhan Jagannathan, Armin Shivazad, Michael Kolan
BACKGROUND: Tracheal extubation in children with difficult airways may be associated with an increased risk of perioperative adverse events. AIMS: The aim of this study was to describe the exubation techniques used/ success rates/ adverse events related to tracheal extubation practices in children with difficult airways. METHODS: A retrospective analysis of tracheal extubation practices in the difficult airway population over a 78-month period was performed...
April 2016: Paediatric Anaesthesia
Carla C Moreira, Alik Farber, Jeffrey A Kalish, Mohammad H Eslami, Sebastian Didato, Denis Rybin, Ghoerghe Doros, Jeffrey J Siracuse
OBJECTIVE: Patients undergoing major lower extremity amputations are at risk for a wide variety of perioperative complications. Elderly patients with any functional impairment have been shown to be at high risk for these adverse events. Our goal was to determine the association between the type of anesthesia-general anesthesia (GA) and regional/spinal anesthesia (RA)-on perioperative outcomes after lower extremity amputation in these elderly and functionally impaired patients. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) data set (2005-2012) was queried to identify all patients aged ≥75 years with partial or total functional impairment who underwent major lower extremity amputations...
March 2016: Journal of Vascular Surgery
Susan W J D van Liempt, Katrin Stoecklein, Ming Y Tjiong, Lothar A Schwarte, Christianne J M de Groot, Pim W Teunissen
Cardiac arrest during cesarean section is very rare. Obstetrical teams have low exposure to these critical situations necessitating frequent rehearsal and knowledge of its differential diagnosis and treatment. A 40-year-old woman pregnant with triplets underwent cesarean sections because of vaginal bleeding due to a placenta previa at 35.2 weeks of gestation. Spinal anesthesia was performed. Asystole occurred during uterotomy. Immediate resuscitation and delivery of the neonates eventually resulted in good maternal and neonatal outcomes...
January 28, 2015: Clinics and Practice
Anita Kumari, Ruchi Gupta, Sukhminder Jit Singh Bajwa, Amrinder Singh
Cardiac arrest during anesthesia and perioperative period is a matter of grave concern for any anesthesiologist. But such mishaps have been reported for one reason or the other in the literary sciences. We are reporting the occurrence of unanticipated delayed cardiac arrest following spinal anesthesia in two young and healthy patients. Fortunately, these patients were successfully resuscitated with timely and appropriate cardiopulmonary resuscitative measures. Occurrence of such cases needs timely reporting and exploring all the possible causes of these unusual and possibly avoidable events...
January 2014: Anesthesia, Essays and Researches
Suchitra Malhotra, Kumar Mohinder
It is difficult to predict the neurological outcome in survivor of cardio respiratory arrest. We report a case of 32 year old survivor of respiratory arrest who developed myoclonic jerks following overdose of sedation during spinal anesthesia. We initially thought these to be myoclonic status epilepticus (MSE). Accurate distinction between MSE and Lance-Adams syndrome (LAS) is very important as both have very different prognosis. LAS is a common occurrence in cardiac arrest survivors where the cause is respiratory arrest...
July 2012: Anesthesia, Essays and Researches
Bryce A Basques, Jason O Toy, Daniel D Bohl, Nicholas S Golinvaux, Jonathan N Grauer
BACKGROUND: Total hip arthroplasty may be performed under general or spinal anesthesia. The purpose of the current study was to compare perioperative outcomes between anesthetic types for patients undergoing primary elective total hip arthroplasty. METHODS: Patients who had undergone primary elective total hip arthroplasty from 2010 to 2012 were identified from the American College of Surgeons National Surgical Quality Improvement Program database. Operating room times, length of stay, thirty-day adverse events, and readmission were compared between patients who had received general anesthesia and those who had received spinal anesthesia...
March 18, 2015: Journal of Bone and Joint Surgery. American Volume
Sharma E Joseph, Rebecca D Minehart
A 34-year-old parturient developed third-degree atrioventricular block, in the setting of hypotension, after spinal anesthesia for cesarean delivery. The arrhythmia fully resolved with anticholinergic and sympathomimetic drugs. Considering the increasing maternal morbidity and potential risk of maternal cardiac arrest, this critical state is reviewed, and a treatment algorithm is suggested.
July 1, 2014: A & A Case Reports
Unyime S Ituk, Ashraf S Habib, Carrie M Polin, Terrence K Allen
PURPOSE: This study examines the peripartum anesthetic management and outcomes of women with dilated cardiomyopathy in a large university medical centre over a seven-year period. PRINCIPAL FINDINGS: Twenty-five women were included in this series, 18 with a new diagnosis of cardiomyopathy and seven with a history of cardiomyopathy. Sixteen patients (64%) identified themselves as African American, seven (28%) were Caucasian, and two patients (8%) were Hispanic. The median (range) gestational age at the time of a new diagnosis of cardiomyopathy was 29 (7-38) weeks...
March 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Bn Archana, P Vishnu Prasad, A Sreenivasa Babu
No abstract text is available yet for this article.
March 2014: Indian Journal of Anaesthesia
Meharun-Nissa Khaskheli, Shahla Baloch, Aneela Sheeba
OBJECTIVE: To observe acute maternal morbidity and mortality due to iatrogenic factors and outcomes. METHODS: This observational cross sectional study was conducted at intensive care unit of Liaquat University of Medical and Health sciences Jamshoro from 1-January-2011 to 31-December-2012. In this study all the delivered or undelivered women who needed intensive care unit (ICU) admission due to management related life threatening complication referred from periphery or within this hospital were included, while those women who had pregnancy complicated by medical conditions were excluded...
January 2014: Pakistan Journal of Medical Sciences Quarterly
Lysa P Posner, Christopher L Mariani, Cliff Swanson, Makoto Asakawa, Nigel Campbell, Adam S King
OBJECTIVE: To evaluate and compare perioperative morbidity and mortality in dogs undergoing cervical and thoracolumbar spinal surgery. STUDY DESIGN: Prospective case series. ANIMALS: 157 dogs undergoing cervical or thoracolumbar spinal surgery. METHODS: Data were collected sequentially on canine cases presented from the Neurology Section of the North Carolina State University Veterinary Teaching Hospital for anesthesia and surgery for cervical spinal cord disease...
March 2014: Veterinary Anaesthesia and Analgesia
Joanne Guay, Peter Choi, Santhanam Suresh, Natalie Albert, Sandra Kopp, Nathan Leon Pace
BACKGROUND: Various beneficial effects derived from neuraxial blocks have been reported. However, it is unclear whether these effects have an influence on perioperative mortality and major pulmonary/cardiovascular complications. OBJECTIVES: Our primary objective was to summarize Cochrane systematic reviews that assess the effects of neuraxial blockade on perioperative rates of death, chest infection and myocardial infarction by integrating the evidence from all such reviews that have compared neuraxial blockade with or without general anaesthesia versus general anaesthesia alone for different types of surgery in various populations...
January 25, 2014: Cochrane Database of Systematic Reviews
M O Osazuwa
Spinal anaesthesia is regarded safe for caesarean section. Serious complications resulting from spinal anaesthesia such as cardiac arrest are often times considered rare. This is a case of a 27 year old un-booked gravida1 who was scheduled for emergency caesarean section on account of cephalo-pelvic disproportion (CPD) with associated history of prolonged labour. The patient was preloaded with normal saline one hour before subarachnoid block (SAB) was established and suffered a cardiac arrest immediately after establishing SAB...
April 2013: West African Journal of Medicine
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