Korean J Anesthesiol.  2003 Aug;45(2):286-289. 10.4097/kjae.2003.45.2.286.

Cardiac Arrest during Epidural Anesthesia: A Case Report

• Bang EC
• Lee HS
• Kang YI
• Cho KS
• Kim SY
• Kim SJ

• KMID: 2236729
• DOI: http://doi.org/10.4097/kjae.2003.45.2.286

Abstract

We report a case of sudden cardiac arrest requiring external thoracic cardiac massage in a 40-year old healthy man receiving epidural anesthesia for elective vasovasostomy. The anesthetic procedure was performed in an operating room. Bradycardia and hypotension occurred 10 minutes after local anesthetic injection. Atropine 0.5 mg and ephedrine 10 mg were administered intravenously, but cardiac arrest followed with unconsciousness and apnea. Atropine 0.5 mg and epinephrine 1 mg were administered intravenously, and external cardiac massage was performed synchronously. The heart rate promptly increased, and the consciousness and spontaneous respiration of the patient were restored. Vital signs became stable in the recovery room and the patient recovered with no sequelae. We conclude that sudden bradycardia and cardiac arrest can unexpectedly develop during epidural anesthesia, and that close monitoring of the patient and adequate management are essential.

Keyword

bradycardia; cardiac arrest; epidural anesthesia

MeSH Terms

Adult
Anesthesia, Epidural*
Apnea
Atropine
Bradycardia
Consciousness
Death, Sudden, Cardiac
Ephedrine
Epinephrine
Heart Arrest*
Heart Massage
Heart Rate
Humans
Hypotension
Operating Rooms
Recovery Room
Respiration
Unconsciousness
Vasovasostomy
Vital Signs
Atropine
Ephedrine
Epinephrine