Korean J Anesthesiol.  2004 Jun;46(6):729-734. 10.4097/kjae.2004.46.6.729.

Pulmonary Embolism after Spinal Anesthesia Induction for the Surgical Reduction of a Femur Neck Fracture: A case report

• Park JD
• In JY
• Lee MA
• Kwak HS

• KMID: 2299083
• DOI: http://doi.org/10.4097/kjae.2004.46.6.729

Abstract

This case involved a pulmonary thromboembolism, which originated from the lower extremity. A 68-year-old female, with a femur neck fracture, underwent spinal anesthesia with 0.5% heavy bupivacaine 11 mg for total hip arthroplasty. Ten minutes after the induction of spinal anesthesia, dyspnea, tachycardia and hypotension appeared. Under the impression of a pulmonary embolism, intubation was done and dopamine and epinephrine were infused. The operation stopped and she was sent to the intensive care unit. On the spiral CT chest angiogram, a pulmonary embolism was found. Deep venous thrombosis was detected in the left lower extremity on the venogram. Heparin therapy was started at a rate of 800 U/hour with a bolus of 5000 U. A consultative operation for the removal of deep vein thrombosis was performed by a chest surgeon, and total hip arthroplasty was performed successfully under spinal anesthesia.

Keyword

deep venous thrombosis; femur neck fracture; pulmonary embolism; spinal anesthesia

MeSH Terms

Aged
Anesthesia, Spinal*
Arthroplasty, Replacement, Hip
Bupivacaine
Dopamine
Dyspnea
Epinephrine
Female
Femoral Neck Fractures*
Femur Neck*
Femur*
Heparin
Humans
Hypotension
Intensive Care Units
Intubation
Lower Extremity
Pulmonary Embolism*
Tachycardia
Thorax
Tomography, Spiral Computed
Venous Thrombosis
Bupivacaine
Dopamine
Epinephrine
Heparin