Wenckebach type heart block following spinal anaesthesia for Caesarean section

Abstract

A case is described of complete heart block during spinal anaesthesia for Caesarean section in a fit 23 yr-old-woman. This developed shortly after the institution of the block, with the height of the block below T5 and in the absence of hypotension. The patient was resuscitated successfully with vagolytic and alpha-agonist drugs. A Wenckebach block persisted for a short period postoperatively. The importance of instituting monitoring before the beginning of anaesthesia and the immediate availability of atropine and alpha-agonists before the initiation of spinal anaesthesia is stressed.

Résumé

Cette observation décrit l’apparition d’un bloc auriculoventriculaire complet pendant la rachianesthésie d’un femme de 23 ans en bonne santé subissant une césarienne. Le bloc a fait son apparition tôt après la mise en marche d’une anesthésie sans réaction hypotensive dont le niveau est demeuré sous T5. La patiente a été réanimé efficacement par un vagolytique et un agoniste alpha. Un bloc de Wenckebach a persisté pour une courte période en postopératoire. Les auteurs soulignent l’importance de la mise en place du monitorage et de la disponibilité immédiate de l’atropine et d’un agoniste alpha avant l’initiation d’une anesthésie rachidienne.

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Correspondence to B. F. Matta.

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Matta, B.F., Magee, P. Wenckebach type heart block following spinal anaesthesia for Caesarean section. Can J Anaesth 39, 1067–1068 (1992). https://doi.org/10.1007/BF03008377

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Key words

  • anaesthetic techniques: Spinal
  • complications: heart block
  • heart: arrhythmia, heart block