Cardiac arrest spinal anesthesia

Benjamin Daniel, J P Wanner, Brian Emerson, Jeffrey E Martus
STUDY DESIGN: Case report. OBJECTIVES: To describe intraoperative administration of albumin as a cause of immunoglobulin E (IgE)-mediated anaphylaxis and cardiac arrest in an adolescent with adolescent idiopathic scoliosis. BACKGROUND: Albumin is considered the reference intraoperative colloidal solution, and is used commonly as a volume expander for treating hypovolemia. Albumin rarely causes an anaphylactic reaction, with a documented rate of only 0...
February 6, 2020: Spine Deformity
Ayça T Dumanlı Özcan, Elvin Kesimci, Cemile Altın Balcı, Orhan Kanbak, Hülya Kaşıkara, Abdulkadir But
Background: Bone cement implantation syndrome (BCIS) is characterized by hypoxia hypotension cardiac arrest. There is not any research that investigated the hemodynamic effects of colloid use during and before cement implantation regarding BCIS development. Aims: We aimed to compare the effects of colloid preloading before or coloading simultaneously at cement implantation on BCIS development and hemodynamic parameters in patients who underwent total knee arthroplasty...
October 2018: Anesthesia, Essays and Researches
Caitlin R Woolcott, Stephanie Torrey, Patricia V Turner, Heather Chalmers, Lena J Levison, Karen Schwean-Lardner, Tina M Widowski
Our objective was to determine the efficacy of manual cervical dislocation vs. a mechanical cervical dislocation device for on-farm killing of poults and young turkeys. Forty-two 1- and 3-week old turkeys were randomly assigned to one of three experimental groups: awake manual cervical dislocation (CD), anesthetized manual cervical dislocation (aCD), or anesthetized mechanical cervical dislocation (MCD). Anesthetized birds received an intramuscular dose of 0.3 mg/kg medetomidine and 30 mg/kg of ketamine to achieve a light plane of anesthesia...
2018: Frontiers in Veterinary Science
Chiara Comito, Lorenzo Bechi, Caterina Serena, Vanni Checcucci, Emanuele Mori, Massimo Micaglio, Federico Mecacci, Felice Petraglia
Cardiac arrest in pregnancy is a rare event due to different cause. When it occurs after spinal anesthesia a cause that can explain this event is the Bezold-Jarish Reflex (BJR). A cardiac arrest occurs in a pregnant women after spinal anesthesia admistered for urgent caesarean section. During this event perimortem caesarean delivery (PMCD) is the rapid surgical way that can improve maternal and fetal outcomes. In this situation, it is very important to have a multidisciplinary team of midwives, obstetricians, anesthetists, neonatologists, intensivists that is able to perform perimortem caesarean delivery according to the guidelines...
September 23, 2018: Journal of Maternal-fetal & Neonatal Medicine
Vidhu Bhatnagar, Deepak Dwivedi, Shatabdi Chakraborty, Arijit Ray
Spinal anesthesia (SA) is utilized as an effective means of anesthesia and has an impressive safety record but it is not devoid of complications, and sometimes, the complications are as fatal as cardiac arrest. Although many factors are involved in etiology of cardiac arrest under SA, the vagal responses to the decreased preload are the most common culprits. We report two cases of cardiac arrest under SA; which happened despite our patient being adequately preloaded utilizing the ultrasonography-guided targeted volume therapy...
July 2018: Saudi Journal of Anaesthesia
Bamidele Johnson Alegbeleye
BACKGROUND: Sudden cardiac arrest following spinal anesthesia is relatively uncommon and a matter of grave concern for any anesthesiologist as well as clinicians in general. There have been, however, several reports of such cases in the literature. Careful patient selection, appropriate dosing of the local anesthetic, volume loading, close monitoring, and prompt intervention at the first sign of cardiovascular instability should improve outcomes. The rarity of occurrence and clinical curiosity of this entity suggest reporting of this unusual and possibly avoidable clinical event...
May 24, 2018: Journal of Medical Case Reports
D Chassard
Over the period 2010-2012, maternal mortality linked to anesthesia accounted for 2% of maternal deaths, with no significant change since 2007-2009. Of the 7 maternal deaths analyzed by the expert committee, anesthetic complications were in 5 cases the main cause of death: 4 attributed to direct causes related to anesthetic procedures during childbirth and 1 to indirect cause in connection with an ENT complication during pregnancy. The anesthetic causes of maternal mortality were for the 2010-2012 period: cardiac arrest under spinal anesthesia during caesarean section, local anesthetic intoxication with unsuccessful resuscitation after cardiac arrest without intralipid administration, acute respiratory distress syndrome in the postpartum period after pulmonary aspiration during caesarean section, cardiac arrest during caesarean section under general anesthesia in a context of non-Hodgkin lymphoma with mediastinal syndrome, unsuccessful endotracheal intubation in a context of cellulitis of the oral cavity floor...
December 2017: Gynecologie, Obstetrique, Fertilite & Senologie
Waldemar Elikowski, Małgorzata Małek-Elikowska, Marek Słomczyński, Karolina Horbacka, Jarosław Bartkowski, Bartosz Kalawski
Bupivacaine is a long-acting local anesthetic (LA) used for cutaneous infiltration, peripheral nerve blocks, epidural and spinal anesthesia. However, its application may result in cardiovascular complications such as: hypotension, bradycardia, cardiac arrest and toxic myocardial injury. The authors describe a 53-year-old male with a history of cigarette smoking, admitted for an elective inguinal hernia surgery. Before surgery, the patient received subarachnoid injection of bupivacaine (20 mg). After the operation, he developed transient hypotension...
October 23, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Emmett E Whitaker, Veronica Miler, Jason Bryant, Stephanie Proicou, Rama Jayanthi, Joseph D Tobias
Although generally safe and effective, severe perioperative complications, including cardiac arrest, may occur during general anesthesia in infants. With the emergence of evidence that specific anesthetic agents may affect future neurocognitive outcomes, there has been an increased focus on alternatives to general anesthesia, including spinal anesthesia. We present a case of cardiac arrest during general anesthesia in an infant who required urologic surgery. During the subsequent anesthetic care, spinal anesthesia was offered as an alternative to general anesthesia...
2017: Local and Regional 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...
March 1, 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 2017: 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 anaesthetic 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...
September 2017: 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
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