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    Question Post Spinal Emergency!



    A 50-yr-old, 97-kg, healthy male presented for elective left high tibial osteotomy.

    Spinal anesthesia was induced uneventfully at L3-4 with 11.25 mg of hyperbaric 0.75% bupivacaine and morphine 0.25 mg.

    Thirteen minutes after induction, the incision site was infiltrated with 20 mL of 0.5% bupivacaine with epinephrine 5 microg.mL(-1) for intraoperative hemostasis, resulting in an increase in heart rate from 74 to 90 beats.min(-1). Three minutes after infiltration of the incision site, the patient's heart rate dropped to 48 beats.min(-1), accompanied by a blood pressure of 107/51 mmHg, SpO2 97%, and a sinus bradycardia on the electrocardiogram.

    The electrocardiographic complexes suddenly disappeared with loss of the pulse oximeter waveform. The patient goes Asystolic.

    What do you do?

    What happened?
    Last edited by MmacFN; 03-02-2013 at 07:37 PM.
    Mike

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