This case involved a
pulmonary thromboembolism, which originated from the
lower extremity. A 68-year-old
female, with a
femur neck fracture, underwent
spinal anesthesia with 0.5% heavy
bupivacaine 11 mg for
total hip arthroplasty. Ten minutes after the induction of
spinal anesthesia,
dyspnea,
tachycardia and
hypotension appeared. Under the impression of a
pulmonary embolism,
intubation was done and
dopamine and
epinephrine were infused. The operation stopped and she was sent to the
intensive care unit. On the
spiral CT chest angiogram, a
pulmonary embolism was found.
Deep venous thrombosis was detected in the left
lower extremity on the venogram.
Heparin therapy was started at a rate of 800 U/hour with a bolus of 5000 U. A consultative operation for the removal of
deep vein thrombosis was performed by a
chest surgeon, and
total hip arthroplasty was performed successfully under
spinal anesthesia.