CARDIAC ARREST IN THE RECOVERY ROOM AFTER HAEMORRHOIDECTOMY UNDER SPINAL ANAESTHESIA COMBINED WITH DEXMEDETOMIDINE SEDATION

Öz

Spinal anaesthesia is a frequently preferred neuraxial anaesthesia method that can be used in various surgeries. However, although rare, complications that can progress to cardiac arrest (CA) are encountered. We aimed to present the development and subsequent management of a cardiac arrest, which started with bradycardia, in the recovery unit after haemorrhoid surgery. Our patient had no systemic disease other than regulated hypertension. The predisposing factors, especially dexmedetomidine sedation combined with spinal anaesthesia are discussed. We concluded that dexmedetomidine should be used very carefully, especially in young ASA I patients with a basal heart rate (HR) below 60 bpm, as well as in patients with cardiac disease, due to the increased risk of the severe sympathetic blockade caused by spinal anaesthesia.

Anahtar Kelimeler

• spinal anaesthesia
• dexmedetomidine
• resuscitation

SPİNAL ANESTEZİ VE DEKSMEDETOMİDİN SEDASYONU ALTINDA HEMOROİD CERRAHİSİ YAPILAN HASTADA AYILMA ODASINDA KARDİYAK ARREST GELİŞİMİ

Öz

Spinal anestezi çok çeşitli cerrahilerde kullanılabilen, oldukça sık tercih edilen bir nöroaksiyel anestezi yöntemidir. Fakat nadir de olsa kardiyak arreste (KA) kadar ilerleyebilen komplikasyonlarla karşılaşılmaktadır. Bu vaka raporunda, regüle hipertansiyon dışında sistemik hastalığı bulunmayan hastamızın hemoroid cerrahisi sonrası ayılma ünitesinde bradikardi ile başlayan kardiyak arrest gelişimi ve müdahelesi anlatılmış, başta deksmedetomidin olmak üzere zemin hazırlayan etkenlerin tartışılması amaçlanmıştır. Vakamızdan yola çıkarak spinal anestezinin kardiyovasküler sistem üzerindeki etkilerini de düşündüğümüzde uygulama sırasında oluşabilen sempatik blokajın şiddetini arttırabilecek, özellikle vagal tonus artışı olan, bazal kalp atım hızı (KH) 60 dk-1 altındaki ASA I genç bireylerde ve özellikle kardiyak hastalığı bulunan hastalarda deksmedetomidin oldukça dikkatli kullanılmalı ve spinal anestezi sırasında ortaya çıkabilecek komplikasyonlar unutulmamalıdır.

Anahtar Kelimeler

• Spinal anestezi
• deksmedetomidin
• Resüsitasyon

Kaynakça

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