Unexpected Cardiac Arrest during Spinal Anesthesia

Abstract

Intraoperative cardiac arrest in the operating room (CAIOR) is an unexpected and potentially serious event. Two types of CAIOR must be distinguished: those directly attributable to anesthesia and CAIOR of other etiologies, notably surgical. The incidence of CAIOR directly attributable to anesthesia is between 0.5 and 1.86 per 10,000 anesthesias, Through the clinical case of a 62-year-old woman who presented a per operative caradiac arrest during a spinal anesthesia for operative hysteroscopy, and through a review of the literature, we will expose the risk factors of CAIOR, as well as the main etiologies. Symptomatic and etiological treatments must be implemented as soon as possible to avoid the mainly neurological consequences of circulatory failure. The management is based on symptomatic treatment with effective cardiopulmonary resuscitation, especially associated with the etiological treatment of cardiac arrest. But sometimes, the etiology of the cardiac arrest remains unidentified, and the treatment is therefore essentially symptomatic. The mortality rate of CAIOR remains high, the crude mortality rate observed 90 days after CAIOR is estimated at 48% (14) The survival of patients after CAIOR is intimately linked to the precocity and quality of their initial initial management.