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[A case of cardiac arrest with coronary artery spasm during lumbar epidural anesthesia]
Y Kasuya1, Y Okumura, K Tanabe
1Department of Anesthesiology and Critical Care Medicine, Gifu University Hospital, Gifu 500-8705.
A 61-year-old man underwent arthroscopic surgery for internal derangement of the knee joint under epidural anesthesia. Epidural catheterization was performed at the L 2-3 interspace. Operation was started with 10 ml of 1.5% lidocaine. Then 12 ml of 0.375% bupivacaine was added to epidural space. Twenty minutes thereafter, electrocardiogram demonstrated marked elevation of ST segment and atrio-ventricular dissociation, followed by cardiac arrest. Cardiopulmonary resuscitation was started immediately and after 25 minutes normal sinus rhythm was restored. The patient recovered with no neurological sequelae. Coronary angiogram examination was performed but no significant stenosis of coronary artery was observed. Coronary artery spasm caused by lumbar epidural anesthesia was suspected.
A 61-year-old man underwent arthroscopic surgery for internal derangement of the knee joint under epidural anesthesia. Epidural catheterization was performed at the L 2-3 interspace. Operation was started with 10 ml of 1.5% lidocaine. Then 12 ml of 0.375% bupivacaine was added to epidural space. Twenty minutes thereafter, electrocardiogram demonstrated marked elevation of ST segment and atrio-ventricular dissociation, followed by cardiac arrest. Cardiopulmonary resuscitation was started immediately and after 25 minutes normal sinus rhythm was restored. The patient recovered with no neurological sequelae. Coronary angiogram examination was performed but no significant stenosis of coronary artery was observed. Coronary artery spasm caused by lumbar epidural anesthesia was suspected.