title: Myocardial stunning after resuscitation from cardiac arrest following spinal anaesthesia.
abstract: Cardiac arrest associated with spinal anaesthesia has been well researched. Myocardial stunning after successful resuscitation from cardiac arrest is seen in up to 2/3(rd) of in-hospital cardiac arrests. Myocardial stunning after resuscitation from cardiac arrest associated with spinal anaesthesia has probably not been reported earlier. Our case, an ASA physical status I lady, posted for tubal reanastomosis surgery developed bradycardia followed by asystole, approximately 5 minutes after giving subarachnoid block. Return of spontaneous circulation (ROSC) was achieved within 2 minutes with cardiopulmonary resuscitation (CPR) and defibrillation for pulseless ventricular tachycardia. Patient developed delayed pulmonary oedema, which was probably due to myocardial stunning. In the present case, inadequate preloading could have precipitated bradycardia progressing to cardiac arrest which, after resuscitation led to reversible myocardial dysfunction. We conclude that early vasopressor infusion, titrated fluids and echocardiography should be considered in immediate post cardiac arrest phase following spinal anaesthesia.
authors: Department of Anesthesiology, Madha Medical College and Research Institute, Chennai, Tamil Nadu, India.
authors: Pranjali Madhav
authors: PM
authors: Kurhekar
authors: Department of Anesthesiology, Madha Medical College and Research Institute, Chennai, Tamil Nadu, India.
authors: Vsg
authors: V
authors: Yachendra
authors: Department of Anesthesiology, Madha Medical College and Research Institute, Chennai, Tamil Nadu, India.
authors: Simi P
authors: SP
authors: Babu
authors: Department of Anesthesiology, Madha Medical College and Research Institute, Chennai, Tamil Nadu, India.
authors: Raghavelu
authors: R
authors: Govindasamy
keywords: Cardiopulmonary resuscitation; myocardial stunning; spinal anaesthesia