Death potentially secondary to sub-Tenon's block.
An 82-year-old ASA 2 patient underwent routine sub-Tenon's block for cataract surgery. One minute after injection of the local anaesthetic, the patient had a generalised tonic-clonic seizure and developed refractory ventricular fibrillation; subsequent resuscitation was unsuccessful. With no evidence for intravascular injection, the lack of structural brain abnormalities, and the most striking feature on post mortem examination being severe triple vessel coronary artery disease, it was concluded that this was primarily cardiac in origin; however, the possibility of brainstem anaesthesia should also be considered.
Quantock
C L
CL
Eastbourne District General Hospital, Eastbourne, UK. drchrisq@yahoo.co.uk
Goswami
T
T
D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects; D002387:Cataract Extraction; D017809:Fatal Outcome; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced*; D006801:Humans; D007431:Intraoperative Complications; D012640:Seizures / Q000139:chemically induced; D014693:Ventricular Fibrillation / Q000139:chemically induced
D000779:Anesthetics, Local