Hypotension and bradycardia before spinal anesthesia

Carlos Javier Shiraishi Zapata

doi:10.1016/j.bjane.2014.12.008

Clinical Informations

Hypotension and bradycardia before spinal anesthesia

Hipotensão e bradicardia antes da raquianestesia

Carlos Javier Shiraishi Zapata

http://dx.doi.org/10.1016/j.bjane.2014.12.008 Braz J Anesthesiol, vol.67, n5, p.535-537, 2017

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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.

Keywords

Hypotension, Bradycardia, Vagal tone, Antihypertensives drugs

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.

Palavras-chave

Hipotensão, Bradicardia, Tônus vagal, Medicamentos anti-hipertensivos

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Hypotension and bradycardia before spinal anesthesia

Hipotensão e bradicardia antes da raquianestesia

Carlos Javier Shiraishi Zapata

Abstract

Keywords

Resumo

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