Death potentially secondary to sub-Tenon's block
1Eastbourne District General Hospital, Eastbourne, UK. drchrisq@yahoo.co.uk
Anaesthesia
|January 17, 2007
Summary
A patient experienced a seizure and cardiac arrest after a routine eye surgery block. The cause was likely severe coronary artery disease, but brainstem anesthesia remains a possibility.
Area of Science:
- Ophthalmology
- Anesthesiology
- Cardiology
Background:
- Routine sub-Tenon's block is a common procedure for cataract surgery.
- Patient was an 82-year-old male with ASA 2 classification.
- Local anesthetic injection is generally safe but carries potential risks.
Observation:
- Generalized tonic-clonic seizure occurred one minute post-injection.
- Refractory ventricular fibrillation developed, leading to unsuccessful resuscitation.
- Post-mortem examination revealed severe triple vessel coronary artery disease.
Findings:
- The primary cause of death was concluded to be cardiac in origin.
- Intravascular injection of local anesthetic was ruled out.
- No structural brain abnormalities were identified.
Implications:
- Highlights the importance of considering cardiac complications during ophthalmic procedures.
- Suggests potential, though less likely, for brainstem anesthesia as a contributing factor.
- Emphasizes the need for vigilance regarding patient's underlying cardiovascular health.
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