Bronchospasm during Spinal Anesthesia in Elderly Patient with Bronchial Asthma - A case report -

Abstract

Spinal anesthesia is an attractive choice when the surgical sites are in the lower abdominal regions or lower extremities, particularly in patients with bronchial asthma. Spinal anesthesia is believed to reduce the possibility of bronchospasm that might be induced by the stimuli to the airway. Although bronchospasm rarely occurs during spinal anesthesia, it can be life-threatening. We report a case of unexpected fatal bronchospasm that occurred during spinal anesthesia. An 83-year-old female with a history of asthma was scheduled for an open reduction and internal fixa tion of a left femur intertrochanteric fracture. Spinal anesthesia was performed at L4-5 interspace with 6 mg of hyperbaric bupivacaine. The maximum sensory level was T6. Approximately 1 hour after spinal anesthesia was begun, an acute severe bronchospasm, which manifested as expiratory wheezing, occurred after she complained of shortness of breath. The patient did not recover despite receiving the proper treatment. (Korean J Anesthesiol 2008; 54: 98∼101)