Spinal anesthesia cardiac arrest

Many causes of acute spinal cord infarction (of arterial and venous origin) have been reported (Table 17.2). They include diseases of the aorta and aortic surgery, thromboembolic events and cartilaginous disc embolism, vasculitis, coagulopathy, radiation-induced vasculopathy, toxic effects of contrast medium, epidural anesthesia, periradicu-lar nerve root therapy with crystalline corticoids, decompression illness, shock or cardiac arrest, lumbar artery compression and other etiologies... 

Bradycardia occurs in some 3% of spinal anesthetics in adults. Bradycardia can lead to cardiac arrest, either by direct block of the sympathetic innervation of the heart (in unintended high block) or as a consequence of insufficient venous return. In 900 cases of major anesthetic mishaps giving rise to compensation claims, there were 14 cases of cardiac arrest under spinal anesthesia, of which six were fatal (191). Myocardial infarction and cardiac arrest preceded by atrioventricular block have also been described. 

Caplan RA, Ward RJ, Posner K, Cheney FW. Unexpected cardiac arrest during spinal anesthesia a closed claims analysis of predisposing factors. Anesthesiology 1988 68(1) 5-11. 

Death Fatal cardiac arrest following bladder catheterization for urinary retention after spinal anesthesia has been reported [42 ]. 

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