Korean J Anesthesiol.  2008 Jan;54(1):84-87. 10.4097/kjae.2008.54.1.84.

Acute Myocardial Infarction during General Anesthesia Combined with Epidural Anesthesia: A case report

• Chung JH
• Seo YH
• Ahn KR
• Kim CS
• Kang KS
• You SH
• Chung JW

• KMID: 2236578
• DOI: http://doi.org/10.4097/kjae.2008.54.1.84

Abstract

The general anesthesia combined with epidural anesthesia have many advantages, which are including early recovery, postoperative analgesia, and less requirement of inhalation anesthetic. But the complications of epidural anesthesia such as total spinal anesthesia, respiratory depression, myocardial ischemia, and local anesthetic toxicity can lead to cardiac arrest. We report a case of acute myocardial infarction in a 74-year-old female patient receiving general anesthesia combined with epidural anesthesia. The profound hypotension without bradycardia and ST-segment elevation in lead II occurred 1 hour after local anesthetic injection and cardiac arrest followed. After the injection of atropine, epinephrine and dopamine, and external cardiac massage, sinus rhythm was restored. Postoperative serial examinations of ECG showed ST-segment elevation in leads II, III, aVF and serum enzymes such as CPK, CK-MB, and Troponin T were elevated. Emergency percutaneous transluminal coronary angioplasty was performed and the patient recovered uneventfully.

Keyword

acute myocardial infarction; cardiac arrest; epidural anesthesia

MeSH Terms

Aged
Analgesia
Anesthesia, Epidural
Anesthesia, General
Anesthesia, Spinal
Angioplasty, Balloon, Coronary
Atropine
Bradycardia
Dopamine
Electrocardiography
Emergencies
Epinephrine
Female
Heart Arrest
Heart Massage
Humans
Hypotension
Inhalation
Myocardial Infarction
Myocardial Ischemia
Respiratory Insufficiency
Troponin T
Atropine
Dopamine
Epinephrine
Troponin T