[Hypotension and bradycardia before spinal anesthesia].
I report a case of hypotension and bradycardia before spinal anesthesia in a pregnant woman with mild to moderate hypertension treated with nifedipine and methyldopa, scheduled for an elective cesarean delivery. She had the history of neurally-mediated syncopes. Two main factors (increased vagal tone and adverse effects of antihypertensive drugs) could explain the hypotension and bradycardia before spinal anesthesia. Monitoring allowed recognizing the problem and corrected it. Thus, it was avoided a disaster in anesthesia, as hemodynamic changes after spinal anesthesia, they would have joined to previous hypotension and bradycardia, which would have caused even a cardiac arrest.
Hospital Essalud Talara, Servicio de Centro Quirúrgico y Anestesiología, Piura, Peru. Electronic address: shiraishi52@hotmail.com.
Carlos Javier
CJ
Shiraishi Zapata
D000328:Adult; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D001919:Bradycardia / Q000150:complications / Q000175:diagnosis; D002585:Cesarean Section; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced; D007022:Hypotension / Q000150:complications / Q000175:diagnosis; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis; D057234:Preoperative Period
Antihypertensives drugs; Bradicardia; Bradycardia; Hipotensão; Hypotension; Medicamentos anti‐hipertensivos; Tônus vagal; Vagal tone