Pulmonary Embolism after Spinal Anesthesia Induction for the Surgical Reduction of a Femur Neck Fracture: A case report.
10.4097/kjae.2004.46.6.729
- Author:
Jong Deok PARK
1
;
Jun Yong IN
;
Myong Ae LEE
;
Ho Sung KWAK
Author Information
1. Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
deep venous thrombosis;
femur neck fracture;
pulmonary embolism;
spinal anesthesia
- MeSH:
Aged;
Anesthesia, Spinal*;
Arthroplasty, Replacement, Hip;
Bupivacaine;
Dopamine;
Dyspnea;
Epinephrine;
Female;
Femoral Neck Fractures*;
Femur Neck*;
Femur*;
Heparin;
Humans;
Hypotension;
Intensive Care Units;
Intubation;
Lower Extremity;
Pulmonary Embolism*;
Tachycardia;
Thorax;
Tomography, Spiral Computed;
Venous Thrombosis
- From:Korean Journal of Anesthesiology
2004;46(6):729-734
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
This case involved a pulmonary thromboembolism, which originated from the lower extremity. A 68-year-old female, with a femur neck fracture, underwent spinal anesthesia with 0.5% heavy bupivacaine 11 mg for total hip arthroplasty. Ten minutes after the induction of spinal anesthesia, dyspnea, tachycardia and hypotension appeared. Under the impression of a pulmonary embolism, intubation was done and dopamine and epinephrine were infused. The operation stopped and she was sent to the intensive care unit. On the spiral CT chest angiogram, a pulmonary embolism was found. Deep venous thrombosis was detected in the left lower extremity on the venogram. Heparin therapy was started at a rate of 800 U/hour with a bolus of 5000 U. A consultative operation for the removal of deep vein thrombosis was performed by a chest surgeon, and total hip arthroplasty was performed successfully under spinal anesthesia.
