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Hypotension and bradycardia before spinal anesthesia / Hipotensão e bradicardia antes da raquianestesia
Zapata, Carlos Javier Shiraishi.
  • Zapata, Carlos Javier Shiraishi; Hospital ESSALUD Talara. Servicio de Centro Quirúrgico y Anestesiología. Piura. PE
Rev. bras. anestesiol ; 67(5): 535-537, Sept-Oct. 2017.
Article in English | LILACS | ID: biblio-897760
ABSTRACT
Abstract 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.
RESUMO
Resumo Relato de um caso de hipotensão e bradicardia antes da raquianestesia em uma mulher grávida com hipertensão leve a moderada tratada com nifedipina e metildopa, programada para parto cesáreo eletivo. A paciente apresentava história de síncopes neuralmente mediadas. Dois fatores principais (aumento do tônus vagal e efeitos adversos de medicamentos anti-hipertensivos) poderiam explicar a hipotensão e bradicardia antes da raquianestesia. O monitoramento permitiu reconhecer o problema e corrigi-lo. Dessa forma, foi evitado um desastre em anestesia; assim como as alterações hemodinâmicas após a raquianestesia, esses fatores teriam se juntado à hipotensão e bradicardia anterior, o que poderia até ter causado uma parada cardíaca.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Pregnancy Complications, Cardiovascular / Bradycardia / Cesarean Section / Elective Surgical Procedures / Hypertension, Pregnancy-Induced / Hypotension / Anesthesia, Obstetrical / Anesthesia, Spinal Limits: Adult / Female / Humans / Pregnancy Language: English Journal: Rev. bras. anestesiol Journal subject: Anesthesiology Year: 2017 Type: Article Affiliation country: Peru Institution/Affiliation country: Hospital ESSALUD Talara/PE

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Full text: Available Index: LILACS (Americas) Main subject: Pregnancy Complications, Cardiovascular / Bradycardia / Cesarean Section / Elective Surgical Procedures / Hypertension, Pregnancy-Induced / Hypotension / Anesthesia, Obstetrical / Anesthesia, Spinal Limits: Adult / Female / Humans / Pregnancy Language: English Journal: Rev. bras. anestesiol Journal subject: Anesthesiology Year: 2017 Type: Article Affiliation country: Peru Institution/Affiliation country: Hospital ESSALUD Talara/PE