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Third-degree heart block during spinal anesthesia for cesarean delivery
Sharma E Joseph1, Rebecca D Minehart
1From the Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts.
A & a Case Reports
|January 23, 2015
Summary
A 34-year-old woman experienced third-degree atrioventricular block after spinal anesthesia for cesarean delivery. Prompt treatment with anticholinergic and sympathomimetic drugs resolved the critical cardiac arrhythmia.
Area of Science:
- Anesthesiology
- Cardiology
- Obstetrics
Background:
- Spinal anesthesia is commonly used for cesarean delivery.
- Hypotension is a known complication of spinal anesthesia.
- Cardiac arrhythmias, though rare, can occur during cesarean delivery.
Purpose of the Study:
- To report a case of third-degree atrioventricular block following spinal anesthesia.
- To review the critical nature of this complication in parturients.
- To propose a treatment algorithm for managing this condition.
Main Methods:
- Case report of a 34-year-old parturient.
- Administration of spinal anesthesia for cesarean delivery.
- Management of third-degree atrioventricular block with anticholinergic and sympathomimetic drugs.
Main Results:
- The patient developed third-degree atrioventricular block and hypotension post-spinal anesthesia.
- The arrhythmia resolved completely with pharmacologic intervention.
- No long-term sequelae were observed.
Conclusions:
- Third-degree atrioventricular block is a rare but serious complication of spinal anesthesia in parturients.
- Prompt recognition and management with anticholinergic and sympathomimetic agents are crucial.
- A standardized treatment algorithm may improve outcomes and reduce maternal morbidity.
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