[Severe bradycardia and hypotension during epidural anesthesia in a patient undergoing hemorrhoidectomy]

Severe bradycardia and hypotension developed suddenly in two patients undergoing hemorrhoidectomy under lumbar epidural anesthesia in the jackknife position, about 5 to 10 min after epidural administration of buprenorphine. Severe vago-vagal reflex was supposed to have been induced with buprenorphine in a situation where venous return was decreased by epidural anesthesia and the jackknife position.