Short communication, Note

Hemodynamic collapse with cardiac arrest during a high subarachnoid block

IVANA TUDORIĆ ĐENO ; Department of Anaesthesiology and Intensive Medicine, University Hospital Dubrava, Avenija G. ŠuŠka 6, Zagreb, Croatia
NADA NIKIĆ ; Department of Anaesthesiology and Intensive Medicine, University Hospital Dubrava, Avenija G. ŠuŠka 6, Zagreb, Croatia
VIKTOR ĐUZEL ; Department of Anaesthesiology and Intensive Medicine, University Hospital Dubrava, Avenija G. ŠuŠka 6, Zagreb, Croatia
DUBRAVKA SRDOČ ; Department of Radiology, University Hospital Dubrava, Avenija G. Šuška 6, Zagreb, Croatia
PREDRAG PAVIĆ ; Department of Surgery, University Hospital Dubrava, Avenija G. Šuška 6, Zagreb, Croatia
INO HUSEDŽINOVIĆ ; Department of Radiology, University Hospital Dubrava, Avenija G. Šuška 6, Zagreb, Croatia

Abstract

Background: In this case report we tried to identify possible factors
which could be related to developing an inappropriately high subarachnoid block and consequential hemodynamic collapse.

Case report: A 59 year old female patient was predicted for a lower extremity peripheral revascularization procedure.The progressive spread of spinal block with a decrease in blood pressure and slowing of heart rate ultimately resulted in a a bradycardia which lead to cardiac arrest. Since known risk factors were inapparent and CSF volume as a possible reason for the high block was excluded, we measured the segment length from the Th12 to the L5 vertebra with an MRI scan. Values for the respective parameters of lumbar segment length, angle of inclination and de clination, lowest
and highest points of the spinal canal which can be obtained from existing literature were compared to our results and we saw that the lumbar segment length and angle of inclination were not within the described ranges and that the lowest point of the spinal canal was at the cranial margin of the values described in literature. Thus we considered if the shorter lumbar segment and lowest spinal canal point at the Th7 level are responsible for the cranial distribution of the subarachnoid block.

Conclusion: Lumbar segment length, AP and LL diameters of the spinal canal and the lowest spinal canal point could help us identify higher risk groups which might require a modified dose of LA in order to assure optimal care for the patient.

Keywords

Hrčak ID:

69105

URI

https://hrcak.srce.hr/69105

Publication date:

1.6.2011.

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