Cardiac Arrest Following Spinal Anaesthesia With Plain Bupivacaine for Caesarean Section

Abstract

We describe cardiac arrest after plain bupivacaine spinal anaesthesia in a 28-year old woman who was admitted for an elective caesarean section. After preoperative evaluation and premedication she received a spinal anaesthesia in the L3-4 interspace with plain bupivacaine 0.5%. After being replaced in the supine position she reported difficult breathing. Radial pulse and blood pressure were no longer recordable. Cardiopulmonary resuscitation was started immediately, tracheal was intubated and the foetus delivered rapidly. After delivery of a healthy child the patient's pulse became palpable and circulation returned. The patient regained consciousness and the trachea extubated at the end of surgery. She was discharged from the ICU the next day without sequelae. In this paper the disadvantages of plain bupivacaine are discussed. Nigerian Medical Practitioner Vol. 50 (3&4) 2006: pp. 65-67