Female, 29 y.o/62 kg/158 cm/Elective Caesarean Section History of spinal anesthesia previous 4 years, unknown LA used, no important event recorded normal lab values, otherwise healthy mother Spinal anesthesia done in lateral position, aiming L4-L5, with 27 G quincke tip spinal needle, clear CSF, no blood, no paresthesia..LA used was Bupivacaine heavy 12.5 mg+ Epinephrine 0.05 mg, injected slowly with several aspiration Patient turned supine, 45 secs-60 seca post injection, Lead II monitor showed sinus rythm foollowed by Wide Complex QRS 70 bpm suggestive bundle branch block. Patient complained heartburns but no breathing difficulties, sensory test as high as Th 4-5.. VS was stable, MAP around 65-70 (no less), IV Intralipid 75 ml was administered followed by gradual reduction of symptom and several sinus rhythm appearance..3 minutes after 75 ml finished, converted to sinus rhythm and occasionaL PVC, 25 mL more Iintralipid was given, and arrythmia diminished..patient was alert and suffers no more than heartburn. Post op admitted to HCU to evaaluate electrolyte, Magnesium, 12 lead ECG and Trpponin T..
History of spinal anesthesia previous 4 years, unknown LA used, no important event recorded
normal lab values, otherwise healthy mother
Spinal anesthesia done in lateral position, aiming L4-L5, with 27 G quincke tip spinal needle, clear CSF, no blood, no paresthesia..LA used was Bupivacaine heavy 12.5 mg+ Epinephrine 0.05 mg, injected slowly with several aspiration
Patient turned supine, 45 secs-60 seca post injection, Lead II monitor showed sinus rythm foollowed by Wide Complex QRS 70 bpm suggestive bundle branch block. Patient complained heartburns but no breathing difficulties, sensory test as high as Th 4-5..
VS was stable, MAP around 65-70 (no less), IV Intralipid 75 ml was administered followed by gradual reduction of symptom and several sinus rhythm appearance..3 minutes after 75 ml finished, converted to sinus rhythm and occasionaL PVC, 25 mL more Iintralipid was given, and arrythmia diminished..patient was alert and suffers no more than heartburn.
Post op admitted to HCU to evaaluate electrolyte, Magnesium, 12 lead ECG and Trpponin T..