Complete heart block after epidural anaesthesia in a patient on beta-blocker
Tripathi, M.; Singh, P.K.
Journal of the Indian Medical Association 92(2): 53-54
1994
ISSN/ISBN: 0019-5847 PMID: 8071557 Document Number: 6432
Bradycardia and hypotension are the usual sequelae of spinal as well as epidural block. Mackey et al have suggested that sympathetic blockade during spinal or epidural block is associated with decreased venous return and cardiac volume. This leads to activation of Bezold - Jarish reflex, the mechanoreceptors stimulated in the left ventricular inferior wall leads to reflex parasympathetic activation and thus bradycardia and hypotension. Atropine and rapid fluid infusion usually improve this condition. The present case developed complete heart block following single dose lumbar epidural block, his bradycardia failed to respond to atropine. Isoprenaline infusion reverted the complete heart block. The management and various predisposing factors are discussed.
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