Parada cardíaca após peridural para cirurgia plástica estética: relato de caso

Abstract

Cardiac arrest during neuraxial anesthesia is a serious adverse event, which may lead to significant neurological damage and death if not treated promptly. The associated mechanisms are neglected respiratory failure, extensive sympathetic block, local anaesthetic toxicity, total spinal block, in addition to the growing awareness of the vagal predominance as a predisposing factor. In the case reported, the patient was 25 years old, ASA I, scheduled for aesthetic lipoplasty. After sedation with midazolam and fentany, epidural anesthesia in interspaces T12-L1 and T2-T3 and catheter insertion into inferior puncture were performed. The patient remained in the supine position for 10minutes. Then, she was placed in the prone position, developing asystolic cardiac arrest 20minutes after the completion of neuraxial blockade. The medical team immediately placed the patient in the supine position and began cardiopulmonary resuscitation. Spontaneous circulation was achieved after twenty minutes of resuscitation. We discuss in this report the exacerbated vagal response as the main event mechanism. The patient's successful outcome emphasizes the importance of anaesthetic monitoring by anesthesiologists, prompt recognition and treatment of rhythm changes on the electrocardiogram.

A Influência Da Espiritualidade No Tratamento Da Pessoa Com Dependência Química

“…Entretanto, apesar de ser um efeito considerado desejável, é de suma importância o controle deste a fim de evitar uma maior complicação, desenvolvendo-se uma parada cardíaca (IMBELONI, 1988). Pinheiro et al (2017) afirmam que o uso de anestesia peridural apresenta uma significativa redução da incidência de infarto do miocárdio durante o período perioperatório. Porém, o procedimento não está isento dos riscos de uma possível parada cardiorrespiratória.…”