Periosteal nociceptors induced hypotension and bradycardia under spinal anesthesia -A report of two cases-
نویسندگان
چکیده
The sudden hemodynamic disturbance in the perioperative period can occur because of various surgical and anesthetic reasons but hemodynamic collapse due to noxious stimulus of periosteum stripping has not been described. We report two cases of severe hypotension and bradycardia during periosteum stripping in orthopedic surgery under subarachnoid block even though the block level was adequate. In our patients, hemodynamic collapse occurred specifically at a moment when surgeons manipulated periosteum and fall in blood pressure and heart rate was sudden in onset. The hemodynamic disturbance did not appear to be related to vagally mediated or due to blockade of sympathetic fibers but appeared to be related to periosteal nociceptors.
منابع مشابه
The Effect of Prophylactic Infusion of Combined Ephedrin and Phenylephrine on Maternal Hemodynamic after Spinal Anesthesia for Cesarean Section: A Randomized Clinical Trial
Several techniques have been proposed to prevent hypotension in obstetric patients. Ephedrine and phenylephrine are individually used to prevent maternal hypotension; however, each has its own drawbacks. Some researchers have reported that the infusion of combined ephedrine and phenylephrine immediately after spinal anesthesia for cesarean delivery reduces the incidence of maternal hypotension....
متن کاملUnexpected bradycardia and cardiac arrest under spinal anesthesia: case reports and review of literature.
Spinal anesthesia has been regarded as safe and simple technique since its introduction into anesthesia practice. Bradycardia and hypotension under spinal anesthesia is a known phenomenon. However sudden unexpected bradycardia and cardiac arrest under spinal anesthesia is considered as rare and uncommon manifestation. On the contrary, as per current reviews, severe bradycardia and cardiac arres...
متن کاملManagement of Hypotension and Bradycardia Caused by Spinal Cord Injury. The Usefulness of Midodrine and Methylxanthines
Spinal cord injury is a devastating chronic condition resulting in temporary or permanent motor,sensory or autonomic dysfunction of the cord. The manifestation of spinal cord injury based onthe severity and involved areas could be different. Numerous studies have demonstrated thatbradycardia, hypotension, and orthostatic hypotension are present insignificant number ofpat...
متن کاملManagement of Hypotension and Bradycardia Caused by Spinal Cord Injury. The Usefulness of Midodrine and Methylxanthines
Spinal cord injury is a devastating chronic condition resulting in temporary or permanent motor,sensory or autonomic dysfunction of the cord. The manifestation of spinal cord injury based onthe severity and involved areas could be different. Numerous studies have demonstrated thatbradycardia, hypotension, and orthostatic hypotension are present insignificant number ofpat...
متن کاملSudden occurence of hypotension and bradycardia during greenlight laser transurethral resection of prostate: case report of two cases
BACKGROUND Greenlight laser transurethral resection of prostate (TURP) is a standard surgical method used to treat patients with prostate gland enlargement, it is safe and effective. CASE PRESENTATION We report two cases of sudden occurence of hypotension and bradycardia during greenlight laser TURP. Two patients with benign prostatic hypertrophy were scheduled for greenlight laser TURP under...
متن کامل