Bradycardia and asystolic cardiac arrest during spinal anaesthesia: A report of five cases

Løvstad, R. Z.; Granhus, G.; Hetland, Sidsel

doi:10.1034/j.1399-6576.2000.440109.x

Cited by 74 publications

(46 citation statements)

References 20 publications

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“…Glasser et al [11] in line with our study, reported that levobupivacaine, compared with bupivacaine, causes less bradycardia, and that reduces arterial pressure less.…”

Section: Discussionsupporting

confidence: 80%

“…To prevent unilateral or saddle blocks, patients should move from the lateral or sitting position rapidly and after mobilization of the patients, extension or early return of the block may be seen. Hyperbaric solutions may couse sudden cardiac arrest after spinal anesthesia because of the extension of the sympathetic block [10,11]. The use of truly isobaric solutions may prove less sensitive to position issues.…”

Section: Introductionmentioning

confidence: 99%

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A Comparison of Spinal Anesthesia with Levobupivacaine and Hyperbaric Bupivacaine for Cesarean Sections: A Randomized Trial

Güler¹,

Cakir²,

Ülgey³

et al. 2012

OJAnes

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Purpose: Levobupivacaine showed a lower risk of cardiovascular and central nervous system (CNS) toxicity than bupivacaine which is the most popular local anesthetic agent in obstetric practice. The aim of this study was to investigate the clinical efficacy of levobupivacaine compared with hyperbaric bupivacaine for spinal anesthesia for cesarean section. Methods: 60 pregnant women in ASA I -II group scheduled to have elective cesarean operation were allocated into the study. Patients were randomly divided into two groups. The combinations 10 mg levobupivacaine (0.5%) + fentanyl (15 µcg) for Group LF (n = 30) patients, 10 mg hyperbaric bupivacaine (0.5%) + fentanyl (15 µcg) for BF (n = 30) patients were intrathecally administrated a total of 2.3 cc. Sensory and motor block characteristics of the groups were assessed with pinprick and Bromage scale; observed hemodynamic changes and side effects were recorded. Results: The time to reach maximum dermatome for the sensory block, time to regression by two dermatomes and time to regress to T12 dermatome was found to be significantly long in Group BF. It was observed that in Group BF, the evolution of the motor block was faster and lasted longer. Whereas hypotension, bradycardia and nausea were less in Group LF, the need for ephedrine was higher in Group BF (p < 0.05). Conclusion: Since motor block time is shorter, and side effects like hypotension, bradycardia and nausea are less, the combination of levobupivacaine + fentanyl can be a good alternative in cesarean sections.

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“…Glasser et al [11] in line with our study, reported that levobupivacaine, compared with bupivacaine, causes less bradycardia, and that reduces arterial pressure less.…”

Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

A Comparison of Spinal Anesthesia with Levobupivacaine and Hyperbaric Bupivacaine for Cesarean Sections: A Randomized Trial

Güler¹,

Cakir²,

Ülgey³

et al. 2012

OJAnes

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“…Prompt intervention is necessary to avoid life-threatening circulatory collapse. 22,32 One ventricular arrhythmia was caused by accidental iv injection of local anesthetic, and is a reminder that full resuscitation facilities are needed when performing regional anesthesia.…”

Section: Arrhythmiamentioning

confidence: 99%

Serious intraoperative problems — a five-year review of 83,844 anesthetics

Fasting

Gisvold

2002

Can J Anesth/J Can Anesth

124

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P Pu ur rp po os se e: : The low incidence of mortality and major morbidity in anesthesia makes it difficult to study the pattern of potential accidents and to develop preventive strategies. Anesthetic 'near-misses', however, occur more frequently. Using data from a simple routine-based system of problem reporting, we have analyzed the pattern and causes of serious non-fatal problems, in order to improve preventive strategies. M Me et th ho od ds s: :We prospectively recorded anesthesia-related information from all anesthetics for five years. The data included intraoperative problems, which were graded into four levels, according to severity. We analyzed only the serious nonfatal problems, which were sorted according to clinical presentation, and also according to which factor was most important in the development of the problem. We assessed any untoward consequences for the patient, and whether the problems could have been prevented. R Re es su ul lt ts s: : Serious problems were recorded in 315 cases out of 83,844 (0.4%). Anesthesia was considered the major contributing factor in 111 cases. Difficult intubation, difficult emergence from general anesthesia, allergic reactions, arrhythmia and hypotension were the dominating problems. Twenty-six anesthesia related problems resulted in changes in level of postoperative care, and one patient later died in the intensive care unit after anaphylactic shock. Eighty-two problems could have been prevented by simple strategies.C Co on nc cl lu us si io on n: : Analysis of serious nonfatal problems during anesthesia may contribute to improved preventive strategies. Data from a routine-based system are suitable for this type of analysis. Intubation, emergence, arrhythmia, hypotension and anaphylaxis cause most serious problems, and should be the object of preventive strategies. Objectif : La faible incidence de mortalité et de morbidité importante en anesthésie complique l'étude des types d'accidents potentiels et la

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“…This may lead to hypoxaemic cardiac arrest [1]. The risk of this may be reduced by using low dose LA.…”

mentioning

confidence: 99%

The use of low dose plain solutions of local anaesthetic agents for spinal anaesthesia in the prone position: bupivacaine compared with levobupivacaine

Cuvas¹,

Güleç

Karaaslan

et al. 2008

Anaesthesia

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SummaryIn this study, we aimed to test the hypothesis that 1-ml plain solution of 0.5% bupivacaine or 0.5% levopubivacaine administered in a subarachnoid block can provide adequate anaesthesia and operating conditions for pilonidal cyst ⁄ sinus operations performed in the prone position. There were no significant differences between the two groups in terms of patient demographic data, duration of operation, patient-surgeon satisfaction, haemodynamic changes and side effects. There were no significant differences found in the onset time, highest block level achieved, two segment regression, time to S 2 regression of sensory block and the number of anaesthetised dermatomes, between the two groups (p = 0.077, 0.057, 0.091, 0.084 and 0.057 respectively). The incidence of complete motor blockade was 16% and 8% in Group B at the start and at the end of the operation. There was no complete motor blockade in Group L (p = 0.110 and 0.490 respectively). We conclude that both regimens are effective and safe for use in subarachnoid anaesthesia for pilonidal cyst ⁄ sinus operations performed in the prone position.

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Bradycardia and asystolic cardiac arrest during spinal anaesthesia: A report of five cases

Cited by 74 publications

References 20 publications

A Comparison of Spinal Anesthesia with Levobupivacaine and Hyperbaric Bupivacaine for Cesarean Sections: A Randomized Trial

A Comparison of Spinal Anesthesia with Levobupivacaine and Hyperbaric Bupivacaine for Cesarean Sections: A Randomized Trial

Serious intraoperative problems — a five-year review of 83,844 anesthetics

The use of low dose plain solutions of local anaesthetic agents for spinal anaesthesia in the prone position: bupivacaine compared with levobupivacaine

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