Droperidol and Spinal Anesthesia

Fortuna, A

doi:10.1213/00000539-198408000-00016

Cited by 6 publications

(4 citation statements)

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“…It has been suggested recently that the combination of sympathetic blockade produced by high spinal anesthesia and the vagolytic effect of fentanyl might account for the sudden appearance of bradycardia [ 24 ]. Drugs such as droperidol can also lead to severe hypotension and sudden cardiac arrest during spinal anesthesia on account of their α-blocking effect [ 25 ]. Patients on beta blockers and other alternative medicines provide another challenging situation as the cardiac arrest in these patients can be refractory as vasoconstriction mechanisms in the peripheral vasculature may be impaired [ 3 , 11 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

RETRACTED ARTICLE: Sudden cardiac arrest under spinal anesthesia in a mission hospital: a case report and review of the literature

Alegbeleye

2018

J Med Case Reports

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BackgroundSudden 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.Case presentationWe report the occurrence of unanticipated delayed cardiac arrest following spinal anesthesia in a 25-year-old Cameroonian man. Incidentally, the index patient was successfully resuscitated with timely and appropriate cardiopulmonary resuscitative measures. He went ahead to have emergency open appendectomy with good post-operative outcome and recovery.ConclusionsThe management of such cardiac arrest under spinal anesthesia is very challenging in resource- limited settings such as ours. Anesthetists and clinicians need to be well informed of this grave complication. A good understanding of the physiologic changes caused by spinal anesthesia and its complications, adequate patient selection, respecting the contraindications of the procedure, adequate monitoring, and constant vigilance are of paramount importance to the eventual outcome.

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Section: Discussionmentioning

confidence: 99%

RETRACTED ARTICLE: Sudden cardiac arrest under spinal anesthesia in a mission hospital: a case report and review of the literature

Alegbeleye

2018

J Med Case Reports

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“…Various hypotheses have been proposed, invoking factors such as unrecognized respiratory depression, excessive sedation concurrent with a high block, underappreciation of both the direct and indirect circulatory consequences of a high spinal anesthetic, and failure to rescue with airway management and drugs 8,9,23-26. Hypoxemia from hypoventilation is an unlikely etiology because there are case reports documenting adequate oxygen saturation in these patients.…”

Section: Partmentioning

confidence: 99%

Anesthesia advanced circulatory life support

Moitra

Gabrielli

Maccioli³

et al. 2012

Can J Anesth/J Can Anesth

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PurposeThe constellation of advanced cardiac life support (ACLS) events, such as gas embolism, local anesthetic overdose, and spinal bradycardia, in the perioperative setting differs from events in the pre-hospital arena. As a result, modification of traditional ACLS protocols allows for more specific etiology-based resuscitation.Principal findingsPerioperative arrests are both uncommon and heterogeneous and have not been described or studied to the same extent as cardiac arrest in the community. These crises are usually witnessed, frequently anticipated, and involve a rescuer physician with knowledge of the patient’s comorbidities and coexisting anesthetic or surgically related pathophysiology. When the health care provider identifies the probable cause of arrest, the practitioner has the ability to initiate medical management rapidly.ConclusionsRecommendations for management must be predicated on expert opinion and physiological understanding rather than on the standards currently being used in the generation of ACLS protocols in the community. Adapting ACLS algorithms and considering the differential diagnoses of these perioperative events may prevent cardiac arrest.

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“…[ 15 ] Drugs such as droperidol can also lead to severe hypotension and sudden cardiac arrest during spinal anesthesia on account of their α-blocking effect. [ 16 ] Patients on β blockers and other alternative medicines provide another challenging situations as the cardiac arrest in these patients can be refractory as vasoconstriction mechanisms in the peripheral vasculature may be impaired. [ 2 5 17 ] But in the present clinical situation, both the patients were neither receiving any β blockers or other medications nor any sedation was administered before the occurrence of cardiac arrest.…”

Section: Discussionmentioning

confidence: 99%

Unanticipated cardiac arrest under spinal anesthesia: An unavoidable mystery with review of current literature

Kumari

Bajwa²,

Singh³

2014

Anesth Essays Res

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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. The present case reports are an important addition to a series of recently published mishaps that occurred during spinal anesthesia in young and healthy patients.

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Droperidol and Spinal Anesthesia

Cited by 6 publications

References 0 publications

RETRACTED ARTICLE: Sudden cardiac arrest under spinal anesthesia in a mission hospital: a case report and review of the literature

RETRACTED ARTICLE: Sudden cardiac arrest under spinal anesthesia in a mission hospital: a case report and review of the literature

Anesthesia advanced circulatory life support

Unanticipated cardiac arrest under spinal anesthesia: An unavoidable mystery with review of current literature

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