Reactions 480 - 4 Dec 1993

Bupivacaine/fentanyl

Supraventricular tachycardia and hypotensionduring spinal anaesthesia: case report

Supraventricular tachycardia developed immediately afteradministration of 0.75% IV bupivacaine 1.6ml and IV fentanyl10 µg, for elective spinal anaesthesia before Caesareandelivery, in a 30-year-old woman.

The woman had a 4-month history of palpitations, dizzinessand dyspnoea. She felt faint when the adverse reactionoccurred, and systolic BP was 45mm Hg. Oxygen andephedrine were administered. Her systolic BP increased buther pulse rate was still elevated. She received 3 boluses ofphenylephrine [total dose 300 µg] with subsequent decreaseof pulse rate and stabilisation of systolic BP. The delivery, 35min after the administration of the local anaesthesia, wasuneventful. The patient recovered completely with no furthersequelae.

Author comment: ‘The use of phenylephrine to treat SVT[supraventricular tachycardia] under spinal anaesthesia has notbeen reported. Although cardioversion is recommended for thetreatment of SVT that results in hypotension, under spinalanaesthesia we recommend considering the initial use ofphenylephrine.’Gajraj NM, et al. Supraventricular tachycardia in a parturient under spinalanesthesia. Regional Anesthesia 18: 261-263, Jul-Aug 1993 - USA 807035152

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Reactions 4 Dec 1993 No. 4800114-9954/10/0480-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved