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Belfar AL, Deng Y, Yu RC, Sabbagh A. Successful Use of Continuous Erector Spinae Plane Blocks in a Patient With Variant Angina After Large Ventral Hernia Repair. Tex Heart Inst J 2022; 49:489335. [PMID: 36534113 PMCID: PMC9809071 DOI: 10.14503/thij-21-7624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Coronary artery spasm constitutes the primary underlying pathology of variant angina. Because provocation of coronary artery spasm may occur with both excess sympathetic and excess parasympathetic stimulation, patients with this disorder have extremely limited options for perioperative pain control. This is especially true for procedures involving extensive abdominal incision/manipulation. Whereas neuraxial analgesia might otherwise be appropriate in these cases, several studies have demonstrated that coronary artery spasm can occur as a result of epidural placement, and therefore, that this may not be an optimal choice for patients with variant angina. This report discusses the case of a patient with a preexisting diagnosis of variant angina who underwent an exploratory laparotomy with large ventral hernia repair and for whom continuous erector spinae plane blocks were successfully used as analgesic adjuncts without triggering coronary artery spasm.
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Affiliation(s)
| | - Yi Deng
- Department of Anesthesiology, Baylor College of Medicine, Houston, Texas
| | - Raymond C. Yu
- Department of Anesthesiology, Allegheny Health Network, Pittsburgh, Pennsylvania
| | - Annas Sabbagh
- Department of Anesthesiology, Allegheny Health Network, Pittsburgh, Pennsylvania
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Hachisuka M, Fujimoto Y, Oka E, Hayashi H, Yamamoto T, Murata H, Yodogawa K, Iwasaki YK, Hayashi M, Miyauchi Y, Shimizu W. Perioperative coronary artery spasms in patients undergoing catheter ablation of atrial fibrillation. J Interv Card Electrophysiol 2022; 64:77-83. [PMID: 34773218 PMCID: PMC9236998 DOI: 10.1007/s10840-021-01089-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 11/04/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE Catheter ablation (CA) is an established treatment for atrial fibrillation (AF). Although coronary artery spasms (CAS) during or after ablation procedures have been described as a rare complication in some case reports, the incidence and characteristics of this complication have not been fully elucidated. The present observational study aimed to clarify the CAS in a large number of patients experiencing AF ablation. METHODS A total of 2913 consecutive patients (male: 78%, mean 66 ± 10 years) who underwent catheter ablation of AF were enrolled. RESULTS Nine patients (0.31%, mean 66 ± 10 years, 7 males) had transient ST-T elevation (STE). Eight out of the 9 patients had STE in the inferior leads. STE occurred after the transseptal puncture in 7 patients, after the sheath was pulled out of the left atrium in 1, and 2 h after the ablation procedure in 1. Six patients had definite angiographic CAS without any sign of an air embolization on the emergent coronary angiography. In the3 other patients, the STE improved either directly after an infusion of nitroglycerin or spontaneously before the CAG. The patients with CAS had a higher frequency of a smoking habit (89% vs. 53%; P = .04), smaller left atrial diameter (36 ± 6 vs. 40 ± 7; P = .07), and lower CHADS2 score (0.6 ± 0.5 vs. 1.3 ± 1.1; P = .004) than those without. CONCLUSIONS Although the incidence was rare (0.31%), CAS should be kept in mind as a potentially life-threatening complication throughout an AF ablation procedure especially performed under conscious sedation.
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Affiliation(s)
- Masato Hachisuka
- Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Yuhi Fujimoto
- Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
| | - Eiichiro Oka
- Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Hiroshi Hayashi
- Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Teppei Yamamoto
- Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Hiroshige Murata
- Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Kenji Yodogawa
- Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Yu-Ki Iwasaki
- Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Meiso Hayashi
- Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
- Mabori Medical Clinic, Yokosuka, Japan
| | - Yasushi Miyauchi
- Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
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Lee JH, Seok JH, Kim YL, Lee JH, Lee SG, Kim EJ, Seo DM. Atropine injection followed by coronary artery spasm with ventricular tachycardia during spinal anesthesia -A case report-. Korean J Anesthesiol 2013; 65:66-70. [PMID: 23904942 PMCID: PMC3726850 DOI: 10.4097/kjae.2013.65.1.66] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Revised: 09/10/2012] [Accepted: 09/12/2012] [Indexed: 12/01/2022] Open
Abstract
Bradycardia may occur during spinal anesthesia with atropine commonly used as a treatment. A 44-year-old female with no known history of any underlying diseases, developed a coronary spasm following ventricular tachycardia when 0.5 mg of atropine was injected intravenously to treat bradycardia during spinal anesthesia. The imbalance caused by atropine in the sympathovagal activity may predispose the coronary artery to develop spasms with ventricular tachycardia. Therefore prudent use of atropine should be accompanied by close monitoring.
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Affiliation(s)
- Joon-Ho Lee
- Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Ji-Hye Seok
- Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Young-Lok Kim
- Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Ji-Hyang Lee
- Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Sang-Gon Lee
- Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Eun-Ju Kim
- Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Da-Mi Seo
- Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea
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4
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Management of cardiac arrest caused by coronary artery spasm: Epinephrine/adrenaline versus nitrates. Heart Lung 2009; 38:228-32. [DOI: 10.1016/j.hrtlng.2008.04.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2007] [Revised: 04/14/2008] [Accepted: 04/16/2008] [Indexed: 11/19/2022]
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5
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Sidi A, Dahleen L, Gaspardone A. Coronary vasospasm during anesthesia induction: awareness, recognition, possible mechanisms, anesthetic factors, and treatment. J Clin Anesth 2008; 20:64-9. [DOI: 10.1016/j.jclinane.2007.02.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2007] [Revised: 01/17/2007] [Accepted: 02/25/2007] [Indexed: 10/22/2022]
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Chung JH, Seo YH, Ahn KR, Kim CS, Kang KS, You SH, Chung JW. Acute Myocardial Infarction during General Anesthesia Combined with Epidural Anesthesia - A case report -. Korean J Anesthesiol 2008. [DOI: 10.4097/kjae.2008.54.1.84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Jin Hun Chung
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Yong Han Seo
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Ki Ryang Ahn
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Chun Sook Kim
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Kyu Sik Kang
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Sie Hyun You
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Ji Weon Chung
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
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RuDusky BM. Perioperative sublingual isosorbide dinitrate for the prevention of cardiac complications in cardiac patients undergoing noncardiac surgery. Angiology 2006; 56:755-60. [PMID: 16327952 DOI: 10.1177/000331970505600613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
One hundred fifty-two consecutive patients with a known or suspected diagnosis of atherosclerotic coronary artery disease were administered 5 mg sublingual isosorbide dinitrate 2 hours and (1/2) hour preoperatively and every 4 hours postoperatively for 3 days, for the prevention of cardiovascular morbidity and mortality, which could result from various noncardiac surgical procedures; 125 patients received general anesthesia. Cardiovascular complications occurred in 3 patients (1.9%). Two patients did not enter the study, owing to side effects of the medication (1.3%). The complications were 1 each (0.6%) of the following: atrial fibrillation, hypotension, and cardiac arrest. Mortality was 0%. These results are exceptionally favorable when compared to the average cardiovascular morbidity rate of 2.8% to 49% in patients assigned to various risk stratifications in the medical literature.
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Affiliation(s)
- Basil M RuDusky
- Northeast Cardiac Clinic and Research Institute, Wilkes-Barre, PA 18701, USA
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Iida R, Yazaki S, Saeki S, Ogawa S. Recurrent ST-segment elevations in a patient without significant coronary disease. J Clin Anesth 2005; 17:372-8. [PMID: 16102690 DOI: 10.1016/j.jclinane.2004.08.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2003] [Accepted: 08/17/2004] [Indexed: 11/22/2022]
Abstract
We report a case of recurrent ST-segment elevations totaling 7 times over 3 hours during subtotal gastrectomy and the early postoperative period in a patient with no history of coronary artery disease. Possible contributing factors include cold stimulus, epidural anesthesia, and inadequate depth of anesthesia. The first episode almost resulted in cardiac arrest and was treated with intravenous epinephrine. The second episode was associated with ventricular fibrillation, which was treated with defibrillation and intravenous verapamil. The third to the seventh episodes were successfully treated with intravenous nitrate. The electrocardiographic changes and postoperative coronary angiography were consistent with a clinical diagnosis of coronary artery spasm. This case suggests that coronary artery spasm is capable of occurring repeatedly in a cyclic pattern during perioperative periods.
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Affiliation(s)
- Ryoji Iida
- Department of Anesthesiology, Surugadai Nihon University Hospital, Tokyo 101-8309, Japan.
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Meissner A, Weber TP, Van Aken H, Rolf N. Limited Upper Thoracic Epidural Block and Splanchnic Perfusion in Dogs. Anesth Analg 1999. [DOI: 10.1213/00000539-199912000-00009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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10
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Meissner A, Weber TP, Van Aken H, Rolf N. Limited upper thoracic epidural block and splanchnic perfusion in dogs. Anesth Analg 1999; 89:1378-81. [PMID: 10589611 DOI: 10.1097/00000539-199912000-00009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
UNLABELLED Epidural blockade leads to a sympathetic block in affected segments and an increase of sympathetic out-flow from various unblocked segments. A limited upper thoracic epidural block (LUTEB) is used during coronary artery surgery affecting the cardiac sympathetic fibers cephalad to the fifth thoracic segment. This block does not extend to the sympathetic fibers innervating the gastrointestinal organs. A LUTEB may lead to an increase of sympathetic activity in the unaffected splanchnic sympathetic segments and the decrease in splanchnic blood flow may contribute to gastrointestinal ischemia after cardiac surgery. We tested the hypothesis that a LUTEB decreases splanchnic perfusion in anesthetized dogs. Thirteen dogs were chronically instrumented with aortic and left atrial catheters, which were used for pressure measurement, as well as injection and withdrawal of reference samples. Thoracic epidural catheters were placed under general anesthesia the day before the experiment. Splanchnic blood flow was determined by using colored microspheres. Induction of a LUTEB did not change general hemodynamics in awake dogs. Propofol anesthesia induced an increase in heart rate that was abolished after LUTEB. LUTEB also decreased mean arterial pressure during propofol anesthesia. We conclude that thoracic epidural anesthesia had no effect on splanchnic blood flow. In propofol anesthetized animals, liver blood flow was increased compared with awake animals; however, it did not change after induction of LUTEB. IMPLICATIONS A sympathetic block in certain segments leads to increased sympathetic output in unblocked segments. For an upper thoracic epidural block, this might lead to impaired splanchnic perfusion. In awake and propofol-anesthetized, chronically instrumented dogs, however, a limited upper thoracic epidural blockade had no compromising effect on gastrointestinal perfusion.
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Affiliation(s)
- A Meissner
- Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin der Westfälischen Wilhelms-Universität Münster, Germany
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Abstract
We report two cases of ventricular fibrillation during noncardiac surgery. Although an emergency coronary angiogram showed no significant coronary stenosis, coronary artery spasm was induced by the intracoronary injection of acetylcholine. It is possible that ventricular fibrillation is caused by coronary artery spasm during noncardiac surgery in patients without overt coronary artery disease.
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Affiliation(s)
- T Nii
- Department of Internal Medicine, Karatsu Red Cross Hospital, Saga, Japan
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Taniguchi M, Kasaba T, Takasaki M. Epidural anesthesia enhances sympathetic nerve activity in the unanesthetized segments in cats. Anesth Analg 1997; 84:391-7. [PMID: 9024036 DOI: 10.1097/00000539-199702000-00029] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
To evaluate compensatory sympathetic excitation during epidural anesthesia, we measured cardiac and renal sympathetic nerve activity during thoracic or lumbar epidural anesthesia in cats. Thirteen cats were divided into three groups: five cats received thoracic epidural anesthesia, five received lumbar epidural anesthesia, and three received lumbar epidural anesthesia after the carotid sinus and vagoaortic nerves were severed (denervated lumbar group). Heart rate (HR), mean arterial pressure (MAP), and cardiac and renal sympathetic nerve activity were measured repeatedly after administration of a single dose of 0.1 mL/kg of 1% lidocaine via the epidural catheter. Epidural solution spread from a median of C-8 to T-6 in the thoracic epidural group, T-8 to L-3 in the lumbar epidural group, and T-7 to L-3 in the denervated lumbar group. During thoracic epidural anesthesia, HR, MAP, and cardiac sympathetic nerve activity decreased, while renal nerve activity increased. Similarly, HR, MAP, and renal sympathetic nerve activity decreased during lumbar epidural anesthesia, and cardiac activity increased. In the denervated lumbar group, HR, MAP, and renal sympathetic nerve activity decreased but cardiac activity remained unchanged. Sympathetic nerve activity in corresponding unanesthetized segments increased during thoracic or lumbar epidural anesthesia in association with significant decreases in MAP and HR. After severance of the carotid sinus and vagoaortic nerves, the absence of sympathetic excitation in the unanesthetized segments during lumbar epidural anesthesia suggests that the compensatory response is produced by the baroreceptor reflex response to anesthesia-induced hypotension.
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Affiliation(s)
- M Taniguchi
- Department of Anesthesiology, Miyazaki Medical College, Japan
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Taniguchi M, Kasaba T, Takasaki M. Epidural Anesthesia Enhances Sympathetic Nerve Activity in the Unanesthetized Segments in Cats. Anesth Analg 1997. [DOI: 10.1213/00000539-199702000-00029] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Hirabayashi Y, Shimizu R, Fukuda H, Saitoh K, Igarashi T. Effects of thoracic vs. lumbar epidural anaesthesia on systemic haemodynamics and coronary circulation in sevoflurane anaesthetized dogs. Acta Anaesthesiol Scand 1996; 40:1127-31. [PMID: 8933854 DOI: 10.1111/j.1399-6576.1996.tb05575.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Although many investigators reported changes in coronary circulation during thoracic epidural anaesthesia (TEA), no previous studies have attempted to compare it with lumbar epidural anaesthesia (LEA) concerning coronary circulation. Our aim was to compare effects of TEA on systemic haemodynamics and coronary circulation with those of LEA in anaesthetized dogs. METHODS In dogs receiving 1.5% sevoflurane, 2% lidocaine (0.1 ml kg-1) was injected into the epidural space via an epidural catheter inserted at either the T7-T8 (TEA group, n = 8) or L5-L6 (LEA group, n = 8) interspace, and the same dose was repeated again 30 min later. RESULTS Heart rate and maximum left ventricular dP/dt decreased in the TEA group but were unchanged in the LEA group. Decreases in mean arterial pressure were found for both groups, and they were more substantial in the TEA than in the LEA group. Decreases in left ventricular minute work index were found for both groups, and they tended to be more substantial in the TEA than in the LEA group. Coronary perfusion pressure and blood flow decreased in both groups. Calculated coronary vascular resistance increased in the TEA group but was unchanged in the LEA group. CONCLUSION The most significant difference between TEA and LEA concerning coronary circulation was characterized by an increase in coronary vascular resistance in the TEA group, which was not present in the LEA group. The increase in coronary vascular resistance caused by TEA may be explained by a coronary vasoconstriction caused by a lower myocardial oxygen demand.
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Affiliation(s)
- Y Hirabayashi
- Department of Anaesthesiology, Jichi Medical School, Tochigi, Japan
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Imamura M, Matsukawa T, Kashimoto S, Nonaka A, Kumazawa T. A case of coronary artery spasm during spinal anesthesia. J Clin Anesth 1996; 8:522-4. [PMID: 8872696 DOI: 10.1016/0952-8180(96)00129-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We present a rare case of coronary artery spasm during spinal anesthesia in a patient who had neither complications nor prior history of coronary artery disease. Some factors are involved in the occurrence of perioperative coronary artery spasm. Many cases of coronary artery spasm during general anesthesia, or general plus epidural anesthesia, have been reported. Although spinal anesthesia by itself has not been reported to be a cause of coronary artery spasm, it is likely, in the current case, that the combination of the activated parasympathetic nerve system by the retraction of the peritoneum and spinal anesthesia might have caused the coronary artery spasm. Anesthesiologists need to be aware that coronary artery spasm may occur during spinal anesthesia, especially when the peritoneum is retracted.
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Affiliation(s)
- M Imamura
- Department of Anesthesiology, Yamanashi Medical University, Japan
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Mizuyama K, Sato S, Okubo N, Naito H. Spinal anesthesia attenuates myocardial ischemia during coronary artery spasm induced by intraaortic methacholine in rats. Acta Anaesthesiol Scand 1995; 39:802-8. [PMID: 7484038 DOI: 10.1111/j.1399-6576.1995.tb04174.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Coronary artery spasm is not rare in patients with coronary artery disease, but the influence of regional anesthesia on spasm-induced myocardial ischemia is not known. We investigated the effects of spinal anesthesia on myocardial ischemia during coronary artery spasm in rats, and compared these with the effects of an alpha- and beta-adrenergic antagonist, and an alpha-adrenergic agonist. An intraaortic catheter was inserted via the right internal carotid artery so that the tip of the catheter was placed near the coronary ostium. An intrathecal catheter was placed at lumbar level. Coronary spasm was induced by the intraaortic injection of methacholine, and we identified the thresholds of myocardial ischemia, defined as the dose of methacholine that induced ST-segment elevation. Subsequently, the thresholds were determined after spinal anesthesia, and after the intraaortic injection of phentolamine and propranolol. The thresholds of myocardial ischemia increased significantly after intrathecal bupivacaine. In contrast, the threshold did not change after the injection of phentolamine. The thresholds increased significantly after the injection of propranolol. Methoxamine significantly decreased the threshold of ischemia. These results demonstrated that spinal anesthesia attenuated myocardial ischemia during methacholine-induced coronary spasm. This effect was equivalent to that of propranolol.
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Affiliation(s)
- K Mizuyama
- Department of Anesthesiology, University of Tsukuba, Japan
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17
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Attenuation of the vagolytic effect of atropine during high thoracic epidural anesthesia by heart rate fluctuation analysis. J Anesth 1995; 9:27-31. [DOI: 10.1007/bf02482031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/1993] [Accepted: 09/09/1994] [Indexed: 11/27/2022]
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Komatsu H, Mitsuhata H, Matsumoto S, Hasegawa J. Isosorbide dinitrate attenuated coronary artery spasm during general anesthesia for non-cardiac surgery. J Anesth 1993; 7:341-5. [PMID: 15278821 DOI: 10.1007/s0054030070341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/1992] [Accepted: 10/21/1992] [Indexed: 10/26/2022]
Affiliation(s)
- H Komatsu
- Department of Anesthesiology, Hiraka General Hospital, Yokote, Akita, Japan
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Mizuyama K, Dohi S, Harukuni I. Coronary artery spasm with ventricular tachycardia after administration of methoxamine during cervical epidural anesthesia--a case report. Acta Anaesthesiol Scand 1993; 37:79-81. [PMID: 8424301 DOI: 10.1111/j.1399-6576.1993.tb03603.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Coronary artery spasm occurred during thoracotomy under cervical epidural anesthesia in a 60-year-old male patient who had no prior history of myocardial ischemia. It is most likely that the administration of methoxamine induced the spasm. Hypotension and venodilatation induced by the epidural anesthesia and increased vagal tone might also contribute to the spasm.
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Affiliation(s)
- K Mizuyama
- Department of Anaesthesiology, University of Tsukuba, Japan
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20
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Okuda T, Wakita K. Recurrent coronary artery spasm during a non-cardiac surgical procedure. J Anesth 1992; 6:503-6. [PMID: 15278528 DOI: 10.1007/s0054020060503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/1991] [Accepted: 02/24/1992] [Indexed: 10/26/2022]
Affiliation(s)
- T Okuda
- Department of Anesthesiology, Kinki University School of Medicine, Osaka, Japan
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21
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Shenaq SA. Con: epidural anesthesia is not a valuable adjunct to general anesthesia for abdominal vascular surgery. JOURNAL OF CARDIOTHORACIC ANESTHESIA 1989; 3:509-12. [PMID: 2520927 DOI: 10.1016/s0888-6296(89)98131-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- S A Shenaq
- Department of Anesthesiology, Baylor College of Medicine Methodist Hospital, Houston, Tx. 77030
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