Severe bradycardia due to Bezold-Jarisch reflex occurred during arousal from dexmedetomidine under spinal and epidural anesthesia: Case report
-
- Mizuta Yukie
- Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University
-
- Daikaku Takafumi
- Department of Orthopedic Surgery, Oita Red Cross Hospital
-
- Fujiyoshi Tetsuhiro
- Department of Anesthesiology, Kyushu Central Hospital
-
- Matsushita Katsuyuki
- Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital
-
- Shirozu Kazuhiro
- Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital
-
- Higashi Midoriko
- Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University
-
- Yamaura Ken
- Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University
Search this article
Description
Severe bradycardia and hypotension during arousal from sedation with dexmedetomidine in a patient with combined spinal and epidural anesthesia is rare. We present a case of a 60-year-old woman who underwent total hip arthroplasty (THA) under combined spinal and epidural anesthesia (CSEA). Severe bradycardia (10 bpm) and hypotension were developed at arousal from sedation with dexmedetomidine prior to the end of the surgery. At that time, she complained of shoulder pain. Cardiac rhythm was restored by the administration of atropine. She was not under high spinal anesthesia. This severe bradycardia was mainly attributed to Bezold-Jarisch reflex (BJR) with decreased preload due to the low concentration of dexmedetomidine and increased inotropic state because of severe pain. BJR may develop during arousal from sedation with dexmedetomidine under combined spinal and epidural anesthesia.
Journal
-
- CIRCULATION CONTROL
-
CIRCULATION CONTROL 44 (2), 99-102, 2023
Japan Society of Circulation Control in Medicine
- Tweet
Keywords
Details 詳細情報について
-
- CRID
- 1390017193112172800
-
- ISSN
- 03891844
-
- Text Lang
- en
-
- Data Source
-
- JaLC
-
- Abstract License Flag
- Disallowed