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Asystole following spinal anaesthesia: the hazards of intrinsic cardiac reflexes

Asystole following spinal anaesthesia: the hazards of intrinsic cardiac reflexes Unwanted initiation of intrinsic cardiac reflexes can precipitate bradycardia and cardiac arrest after spinal anaesthesia. We report the case of a 40‐year‐old man who suffered sudden asystolic cardiac arrest following spinal anaesthesia prior to planned abdominal surgery, likely due to the initiation of one or more intrinsic cardiac reflexes including the Bezold–Jarisch reflex, the reverse Bainbridge reflex and the pacemaker stretch reflex. The characteristics of this patient placed him at increased risk of this underappreciated cause of bradycardia and hypotension. We present a summary of the physiology and clinical features relevant to this case and the considerations for avoidance of similar complications after spinal anaesthesia. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Anaesthesia Reports Wiley

Asystole following spinal anaesthesia: the hazards of intrinsic cardiac reflexes

Lacey, J. R.; Dubowitz, J. A.; Riedel, B.
Anaesthesia Reports , Volume 10 (2) – Jul 1, 2022
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Publisher
Wiley
Copyright
2022 © Association of Anaesthetists
eISSN
2637-3726
DOI
10.1002/anr3.12198
Publisher site
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Abstract

Unwanted initiation of intrinsic cardiac reflexes can precipitate bradycardia and cardiac arrest after spinal anaesthesia. We report the case of a 40‐year‐old man who suffered sudden asystolic cardiac arrest following spinal anaesthesia prior to planned abdominal surgery, likely due to the initiation of one or more intrinsic cardiac reflexes including the Bezold–Jarisch reflex, the reverse Bainbridge reflex and the pacemaker stretch reflex. The characteristics of this patient placed him at increased risk of this underappreciated cause of bradycardia and hypotension. We present a summary of the physiology and clinical features relevant to this case and the considerations for avoidance of similar complications after spinal anaesthesia.

Journal

Anaesthesia Reports – Wiley

Published: Jul 1, 2022

Keywords: bradycardia; cardiac arrest; cardiac reflex; hypotension; spinal anaesthesia

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