Open AccessMyocardial stunning after resuscitation from cardiac arrest following spinal anaesthesia
Author(s) -
Pranjali Kurhekar,
Vsg Yachendra,
Simi P Babu,
Raghavelu Govindasamy
Publication year - 2014
Publication title -
indian journal of anaesthesia/indian journal of anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.645
H-Index - 30
eISSN - 0976-2817
pISSN - 0019-5049
DOI - 10.4103/0019-5049.130828
Subject(s) - medicine , stunning , anesthesia , resuscitation , spinal anesthesia , myocardial stunning , cardiopulmonary resuscitation , clinical death , cardiology , ischemia
Cardiac arrest associated with spinal anaesthesia has been well researched. Myocardial stunning after successful resuscitation from cardiac arrest is seen in up to 2/3(rd) of in-hospital cardiac arrests. Myocardial stunning after resuscitation from cardiac arrest associated with spinal anaesthesia has probably not been reported earlier. Our case, an ASA physical status I lady, posted for tubal reanastomosis surgery developed bradycardia followed by asystole, approximately 5 minutes after giving subarachnoid block. Return of spontaneous circulation (ROSC) was achieved within 2 minutes with cardiopulmonary resuscitation (CPR) and defibrillation for pulseless ventricular tachycardia. Patient developed delayed pulmonary oedema, which was probably due to myocardial stunning. In the present case, inadequate preloading could have precipitated bradycardia progressing to cardiac arrest which, after resuscitation led to reversible myocardial dysfunction. We conclude that early vasopressor infusion, titrated fluids and echocardiography should be considered in immediate post cardiac arrest phase following spinal anaesthesia.