Hypotension and bradycardia before spinal anesthesia
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 ton...
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Format: | Article |
Language: | English |
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Elsevier
2017-09-01
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Series: | Brazilian Journal of Anesthesiology |
Online Access: | http://www.sciencedirect.com/science/article/pii/S0104001415001232 |
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author | Carlos Javier Shiraishi Zapata |
author_facet | Carlos Javier Shiraishi Zapata |
author_sort | Carlos Javier Shiraishi Zapata |
collection | DOAJ |
description | 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. 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 cesário 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. Assim, 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 ter causado inclusive uma parada cardíaca. Keywords: Hypotension, Bradycardia, Vagal tone, Antihypertensives drugs, Palavras-chave: Hipotensão, Bradicardia, Tônus vagal, Medicamentos anti-hipertensivos |
first_indexed | 2024-04-11T10:47:15Z |
format | Article |
id | doaj.art-fc9278a68a344bf4ac9812fdfd419226 |
institution | Directory Open Access Journal |
issn | 0104-0014 |
language | English |
last_indexed | 2024-04-11T10:47:15Z |
publishDate | 2017-09-01 |
publisher | Elsevier |
record_format | Article |
series | Brazilian Journal of Anesthesiology |
spelling | doaj.art-fc9278a68a344bf4ac9812fdfd4192262022-12-22T04:29:01ZengElsevierBrazilian Journal of Anesthesiology0104-00142017-09-01675535537Hypotension and bradycardia before spinal anesthesiaCarlos Javier Shiraishi Zapata0Hospital ESSALUD Talara, Servicio de Centro Quirúrgico y Anestesiología, Piura, PeruI 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. 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 cesário 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. Assim, 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 ter causado inclusive uma parada cardíaca. Keywords: Hypotension, Bradycardia, Vagal tone, Antihypertensives drugs, Palavras-chave: Hipotensão, Bradicardia, Tônus vagal, Medicamentos anti-hipertensivoshttp://www.sciencedirect.com/science/article/pii/S0104001415001232 |
spellingShingle | Carlos Javier Shiraishi Zapata Hypotension and bradycardia before spinal anesthesia Brazilian Journal of Anesthesiology |
title | Hypotension and bradycardia before spinal anesthesia |
title_full | Hypotension and bradycardia before spinal anesthesia |
title_fullStr | Hypotension and bradycardia before spinal anesthesia |
title_full_unstemmed | Hypotension and bradycardia before spinal anesthesia |
title_short | Hypotension and bradycardia before spinal anesthesia |
title_sort | hypotension and bradycardia before spinal anesthesia |
url | http://www.sciencedirect.com/science/article/pii/S0104001415001232 |
work_keys_str_mv | AT carlosjaviershiraishizapata hypotensionandbradycardiabeforespinalanesthesia |