Reactions 874 - 20 Oct 2001

SBupivacaine/fentanyl

Unconsciousness following spinal anaesthesia?:case report

A 27-year-old woman experienced loss of consciousnessduring spinal anaesthesia with bupivacaine and fentanyl for anemergency Caesarean section. She had undergone spinalanaesthesia some years earlier with no adverse effects.

The woman received 2.2ml of hyperbaric bupivacaine 5%and fentanyl 20µg via a 25-gauge pencil point spinal needle.Approximately 25 minutes after the spinal block and soon afterdelivery of the placenta, she became unresponsive; herGlasgow coma score was 3. During the third stage of labourshe had been given oxytocin and cefuroxime, and her arterialBP had decreased from 140/80 to 102/50mm Hg.

The woman was intubated and ventilated with 100%oxygen. She received suxamethonium chloride[succinylcholine]. During the next 15 minutes, her arterial BPincreased to 145/80mm Hg. She had no recollection of theevents.

Author comment: ‘A high spinal, although possible, wouldhave been unlikely due to the volume of drug used, the timeafter the spinal that loss of consciousness occurred (25 min),and the absence of warning symptoms or signs’.Stone J. Loss of consciousness following spinal anaesthesia for caesarean section.British Journal of Anaesthesia 86: 899, Jun 2001 - England 800869826

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Reactions 20 Oct 2001 No. 8740114-9954/10/0874-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved