Unanticipated cardiac arrest under spinal anesthesia: An unavoidable mystery with review of current literature

Abstract

Cardiac arrest during anesthesia and perioperative period is a matter of grave concern for any anesthesiologist. But such mishaps have been reported for one reason or the other in the literary sciences. We are reporting the occurrence of unanticipated delayed cardiac arrest following spinal anesthesia in two young and healthy patients. Fortunately, these patients were successfully resuscitated with timely and appropriate cardiopulmonary resuscitative measures. Occurrence of such cases needs timely reporting and exploring all the possible causes of these unusual and possibly avoidable events. The present case reports are an important addition to a series of recently published mishaps that occurred during spinal anesthesia in young and healthy patients.

RETRACTED ARTICLE: Sudden cardiac arrest under spinal anesthesia in a mission hospital: a case report and review of the literature

“…Spinal anesthesia is considered to be a safe procedure but complications rarely can occur in the clinical scene [ 1 , 2 ]. Ever since Caplan et al [ 6 ] reported 14 cases of cardiac arrest during spinal anesthesia in an American Society of Anesthesiologists closed claim analysis, numerous case reports and reviews have been published [ 7 , 8 ].…”

“…Ever since August Bier administered the first clinical spinal anesthesia more than a century ago, it has become an integral part of the modern day anesthesia practice. Although considered simple to perform and a relatively safe technique, life-threatening complications do occur under spinal anesthesia [ 1 , 2 ]. In the literature, the reported incidence of cardiac arrest is 1.3–18 in 10,000 patients [ 3 – 5 ].…”

Satisfactory spinal anesthesia with a total of 1.5 mg of bupivacaine for transurethral resection of bladder tumor in an elderly patient

“…One of the most serious complications of spinal anesthesia is cardiac arrest [ 17 – 19 ]. The cardiologist suggested the possibility of cardiac arrest in this case.…”

Fractalidade e comportamento caótico da variabilidade da frequência cardíaca como preditores de hipotensão após raquianestesia: protocolo de ensaio clínico randomizado

“…There are reports in the literature of cardiorespiratory arrest right after spinal anesthesia. The rate of complications is inherent to the clinical condition of the patient, the surgical pathology, or reached height of the anesthetic block, however there are reports of cardiorespiratory arrest after spinal anesthesia in healthy patients without previous comorbidities 3,4 . Early identification of greater propensity for complications is essential to reduce the time between diagnosis and conduct, implying a reduction in morbidity and mortality 1,3,4 .…”

“…2 Departmento de Anestesiologia, Hospital Universitário Júlio Bandeira (HUJB) -Cajazeiras (PB), Brasil. 3 Faculdade de Medicina Estácio de Juazeiro do Norte (Estácio FMJ) -Juazeiro do Norte (CE), Brasil. Figure 1: Spectral analysis of a patient from rest to discharge of the PACU, demonstrating a return of the autonomic function after the return of the motor function posterior to the subarachnoid anesthesia.…”