title: Severe autonomic dysreflexia induced cardiac arrest under isoflurane anesthesia in a patient with lower thoracic spine injury.
abstract: We present a case of severe autonomic dysreflexia (AD) progressing to cardiac arrest and death under isoflurane anesthesia. Though AD in chronic cervical spine injury is a common entity, occurrence of such an event in the stage of flaccid paralysis in lower dorsal spinal cord injury is rare, especially under general anesthesia. Manipulation of urinary bladder catheter under light plane of isoflurane anesthesia might be the precipitating factor. Increasing concentration of isoflurane failed to abort the episode or might have aggravated it. High level of suspicion and vigilance is necessary to prevent, diagnose and treat such a condition.
authors.affiliation: Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Jain
authors.forename: Babita
authors.initials: B
authors.lastname: Ghai
authors.forename: Kajal
authors.initials: K
authors.lastname: Jain
authors.forename: Jeetinder K
authors.initials: JK
authors.lastname: Makkar
authors.forename: Kishore
authors.initials: K
authors.lastname: Mangal
authors.forename: Supriya
authors.initials: S
authors.lastname: Sampley
keywords: Autonomic dysreflexia; cardiac arrest; spinal cord injury