A case of cardiac arrest right after postural change in epidural anesthesia

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  • 硬膜外麻酔中の体位変換直後に心停止をきたした１例

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We report a case of 46-year-old man who fell in cardiac arrest right after postural change. He was scheduled for extracorporeal shock wave lithotripsy (ESWL) for pancreatic duct stones under thoracic epidural anesthesia. Epidural catheter had been placed in T8/9 interspace. The patient took a prone position after injection of 1% mepivacaine 6ml, then ESWL was performed. Thirty minutes later, he was returned to supine position, and suddenly fell in standstill. He was resuscitated successfully with cardiac massage and administration of atropine. We postulated that the cardiac arrest was induced by relative vago-tonic condition by epidural anesthesia and postural change. We should pay more attention to the possibility of severe bradycardia and cardiac arrest when postural change is necessary in patients having epidural anesthesia.

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