title: [Intraoperative cardiac arrest due to coronary vasospasm after tourniquet release--a case report].
abstract: A 55-year-old man with no past history of ischemic heart disease underwent open reduction and internal fixation of the right arm because of an open fracture. Under general anesthesia with brachial plexus block, the operation was started after the upper arm had been pressurized at 280 mmHg by tourniquet. The patient had cardiac arrest 15 min after the tourniquet release, and was resuscitated by CPR. Postoperative intracoronary infusion of acetylcholine revealed that the coronary artery is sensitive to the agent, indicating that the intraoperative cardiac arrest might have been due to coronary vasospasm. Although the similar case is rare, attention should be taken during the anesthetic management with the use of tourniquet.
authors.affiliation: Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo 060-8543.
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Satoh
authors.forename: Johji
authors.initials: J
authors.lastname: Arakawa
authors.forename: Hideya
authors.initials: H
authors.lastname: Ohmori
authors.forename: Hiromi
authors.initials: H
authors.lastname: Takahashi
authors.forename: Michiaki
authors.initials: M
authors.lastname: Yamakage
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Namiki
mesh_terms: D000768:Anesthesia, General / Q000379:methods*; D001132:Arm / Q000601:surgery; D001917:Brachial Plexus; D003329:Coronary Vasospasm / Q000150:complications*; D005597:Fractures, Open / Q000601:surgery; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D014111:Tourniquets