Successful resuscitation despite prolonged cardiac arrest in a patient with undiagnosed intracranial lesion: a case report

Authors

  • Kiran B. Patel Department of Anaesthesiolgy, B. J. Medical College, Ahmedabad, Gujarat
  • Madhuri S. Vyas Department of Anaesthesiolgy, B. J. Medical College, Ahmedabad, Gujarat
  • Ananyaruchi S. Sharma Department of Anaesthesiolgy, B. J. Medical College, Ahmedabad, Gujarat
  • Smita Engineer Department of Anaesthesiolgy, B. J. Medical College, Ahmedabad, Gujarat

DOI:

https://doi.org/10.18203/issn.2454-2156.IntJSciRep20160502

Keywords:

Antiarryhthmic and inotropic drugs, Cardiopulmonary arrest and defibrillation, Intracranial space occupying lesion, Spinal anaesthesia, Ventricular tachyarrythmias

Abstract

Perioperative cardiac arrests represent the most serious complication of anesthesia and surgery. It is believed that the incidence and mortality of cardiac arrest has declined because of advanced and increased surgical acuity and patients with extremes of age. We described a case of 31 year old male who had deterioration of cardiorespiratory and hemodynamic status in half an hour period after giving spinal anesthesia for hydrocoele operation. After half an hour of giving spinal anesthesia, patient developed supraventricular tachycardia followed by ventricular tachycardia progressed to cardiorespiratory arrest in a fraction of 2 to 3 minutes. He was unconscious and convulsing. Fortunately, this patient was successfully resuscitated with timely and appropriate measures in form of endotracheal intubation, cardiac defibrillation, antiarrythmic and inotropic cardiac medications and anticonvulsant drugs. Patient was shifted to ICU with ionotropic support and anticonvulsant infusion. Patient had apparently no previous cardiorespiratory or neurological complaints. Post-operative MRI report showed right cerebello-pontine angle cistern lesion suggestive of epidermoid cyst.

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References

Limongi JA, Lins RS. Cardiopulmonary arrest in spinal anaesthesia. Rev Bras Anesthesiol. 2011;61:110-20.

Keenan RL, Boyan CP. Decreasing frequency of anesthetic cardiac arrests. J Clin Aneth. 1991;3:354-457.

Tikkanen J, Hovi-Viander M. Death associated with anaesthesia and surgery in Finland in 1986 compared to 1975. Acta Anaesthesiol. Scand 1995;9:262-7.

Gaba DM. Anaesthesiology as a model for patient safety in health care. Br Med J. 2000;320:785-8.

Cooper JB, Gaba D. No myth: anesthesia is a model for addressing patient safety. Anesthesiology 2002;97:1335-7.

Lagasse RS. Anesthesia safety: model or myth? A review of the published literature and analysis of current original data. Anesthesiology. 2002;97:1609-17.

Sprung J, Warner ME, Contreras MG, Schroeder DR, Beighly CM, Wilson GA, et al. Predictors of survival following cardiac arrest in patients undergoing noncardiac surgery: a study of 5, 18, 294- patients at a tertiary referral center. Anesthesiology. 2003;99:259-69.

Auroy Y, Benhamou D, Bargues L, Ecofffey C, Fallissard B, Mercier FJ. Major complications of regional anesthesia in France: The SOS Regional Anesthesia Hotline Service. Anesthesiology 2002;97:1274-80.

Cooper J. Cardiac arrest during spinal anesthesia. Anesth Analg. 2001;93:245.

Carpenter RL, Caplan RA, Brown DL, Stephenson C, Wu R. Incidence and risk factors for side effects of spinal anaesthesia. Anesthesiology. 1992;76:906-16.

Greene NM. Physiology of spinal anaesthesia, 3rd ed. Baltimore:Williams and Wilkins.1981:75-6.

Bajwa SJ, Bajwa SK, Kaur J, Singh A, Singh A, Parmar SS. Prevention of hypotension and prolongation of postoperative analgesia in emergency caesarean sections: A randomized study with intrathecal clonidine. Int J Crit Illn Inj Sci. 2012;2:63-9.

Rosenberg JM, Wortsman J, Wahr JA, Cryer PE, Gomez-Sanchez CE. Impaired neuroendocrine response mediates refractoriness to cardiopulmonary resuscitation in spinal anesthesia. Crit Care Med. 1998;26:533-7.

Asadi HK, Pollard J. Fully successful resuscitation despite prolonged cardiac arrest. Saudi J Anaesth. 2011;5(3):314-6.

Kumari A, Gupta R, Bajwa SJ, Singh A. Unanticipated cardiac arrest under spinal anaesthesia: An unavoidable mystery with review of current literature. Anesthesia Essays and Researches. 2014;8(1);99-102.

Van Zijl DHS, Dyer RA, Scott Miller RN, James MFM. Supraventricular tachycardia during spinal anaesthesia for caesarian section. Int J Obstet Anesth. 2001;10:202-5.

Jaiswal AK, Gupta D, Verma N, Behari S. Trigeminocardiac reflex: a cause of sudden asystole during cerebellopontine angle surgery. Journal of Clinical Neuroscience. 2010;17(5):641-4.

Chhabra A, Kumar N, Kumar A, Singh N, Sharma BS. Combined spinal epidural anesthesia for cesarean section in a pregnant patient with rare intracranial neoplasm. M. E. J Anesth. 2010;20(4):581-4.

Brzezinski M, Paisansathan C, Bonasera L, Klock PA. Postoperative transtentorial herniation of occult meningioma after uneventful epidural anesthesia. J of Anesth and Clinical Research. 2010;1:105.

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Published

2016-02-25

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Case Reports