title: Transient bradycardia associated with extradural blood patch after inadvertent dural puncture in parturients.
abstract: We have studied prospectively 10 ASA I or II postpartum patients after inadvertent dural puncture during labour. An extradural blood patch (autologous blood 15 ml) was performed within 18 h of delivery, with continuous EEG, upper facial EMG (Datex: Anesthesia and Brain Activity Monitor), pulse oximetry and heart rate measurement before, during and for 30 min after extradural injection. Non-invasive arterial pressure measurements (Dinamap) were recorded at 5-min intervals. After extradural blood patch, a statistically significant (Student's t test, P < 0.05) decrease in heart rate, from a mean baseline of 88.6 (SD 7.31) beat min-1 to 51.3 (7.6) beat min-1, occurred within 122.6 (16.9) s from the time of the EBP. Bradycardia was observed for a mean duration of 12.4 (1.1) s. Upper facial EMG, EEG, SpO2 and arterial pressure did not change.
authors.affiliation: Department of Anesthesiology, University of Louisville, School of Medicine, Kentucky.
authors.forename: P J
authors.initials: PJ
authors.lastname: Andrews
authors.forename: W E
authors.initials: WE
authors.lastname: Ackerman
authors.forename: M
authors.initials: M
authors.lastname: Juneja
authors.forename: V
authors.initials: V
authors.lastname: Cases-Cristobal
authors.forename: B M
authors.initials: BM
authors.lastname: Rigor
mesh_terms: D015360:Analgesia, Epidural / Q000009:adverse effects; D016362:Analgesia, Obstetrical / Q000009:adverse effects*; D017217:Blood Patch, Epidural / Q000009:adverse effects*; D001919:Bradycardia / Q000209:etiology*; D004388:Dura Mater / Q000293:injuries*; D005260:Female; D006261:Headache / Q000209:etiology / Q000628:therapy*; D006801:Humans; D011446:Prospective Studies