severe bradycardia following spinal anesthesia

Authors
Abstract
Case report: severe bradycardia following spinal anesthesia Kalani N 1, Hakimollahi H 2, Sanie MS 3*, Sistani M 4. Introduction: prevalence of Severe and life-threatening bradycardia following spinal anesthesia is about 2.5 percent and in most cases is associated with a high level of anesthesia (high spinal block). Numbness levels higher that T4 are considered to be a risk factor for occurrence of severe bradycardia and even cardiac arrest. History of the patient: A 81-year-old male patient referred to the Peymanieh hospital in Jahrom to have a surgery due to Ayngvaynal hernia and hydrocele. In the anesthesia consultation before surgery, the patient's heart had a sinus rhythm without ECG signs of ischemia, hypertrophy and heart block. 13 minutes after performing spinal, all vital signs were normal and acceptable and incision has not done yet that And without evidence of symptoms of high spinal block observed، the patient's heart rate suddenly dropped to about bpm45. Moments later it was reduced to about bpm22 but Fortunately with injection of atropine and ephedrine heartbeat was normal. Conclusion: The incidence of severe and life-threatening bradycardia is not necessarily associated with high spinal block even in the presence of normal spinal block is predictable and This fact highlights the importance of careful and real-time patient monitoring. Keywords: spinal anesthesia, bradycardia, inguinal hernia and hydrocele.
Keywords

References: 1. Somboonviboon W, Kyokong O, Charuluxananan S, et al. Incidence and risk factors of hypotension and bradycardia after spinal anesthesia for cesarean section. J Med Assoc Thai 2008;91: 181-7. 2. Ou CH, Tsou MY, Ting CK, Chiou CS, Chan KH, Tsai SK. Occurrence of the Bezold-Jarisch reflex during Cesarean section under spinal anesthesia - A case report. Acta Anaesthesiol Taiwan 2004;42: 175-8. 3. Jang YE, Do SH, Song IA. Vasovagal cardiac arrest during spinal anesthesia for Cesarean section - A case report. Korean J Anesthesiol 2013;64:77-81. 4.Coventry DM, McMenemin I, Lawrie S. Bradycardia during intra-abdominal surgery. Modification by pre-operative anticholinergic agents. Anesthesia 1987; 42:835-9. 5. Kinsella SM, Tuckey JP. Perioperative bradycardia and asystole: Relationship to vasovagal syncope and the Bezold-Jarisch reflex. Br J Anaesth 2001;86:859-68. 6. Neumar RW, Otto CW, Link MS, et al. Part 8: Adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010;122:S729-67. 7. Maitra S, Baidya DK, Bhattacharjee S. Near fatal bradycardia during cesarean section under spinal anesthesia: "High spinal" may not be only risk factor. Saudi J Anaesth 2014; 8(Suppl 1): S118–S119. 8. Chung YH, Kim WH, Lee EK, et al. Sudden persistent fetal bradycardia after spinal analgesia for labor pain. Korean J Anesthesiol. 2013 Dec;65(6 Suppl):S99-S100. doi: 10.4097/kjae.2013.65.6S.S99.