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British Journal of Anaesthesia, 1992, Vol. 69, No. 4 401-403
© 1992 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

TRANSIENT BRADYCARDIA ASSOCIATED WITH EXTRADURAL BLOOD PATCH AFTER INADVERTENT DURAL PUNCTURE IN PARTURIENTS

P. J. D. ANDREWS, F.R.C.ANAES., W.E. ACKERMAN, M.D., M. JUNEJA, F.R.C.ANAES., V. CASES-CRISTOBAL, M.D. and B. M. RIGOR, M.D.

Department of Anesthesiology, University of Louisville, School of Medicine 40292 Louisville, Kentucky, U.S.A.
Norton Hospital, Alliant Health Systems 40291 Louisville, Kentucky, U.S.A.

Correspondence to P.J.D.A.

We have studied prospectively 10 ASA I or II postpartum patients after inadvertent dural puncture during labour. An extradural blood patch (autologous blood 15 ml) was performed within 18 h of delivery, with continuous EEG, upper facial EMG (Datex: Anesthesia and Brain Activity Monitor), pulse oximetry and heart rate measurement before, during and for 30 min after extradural injection. Non-invasive arterial pressure measurements (Dinamap) were recorded at 5-min intervals. After extradural blood patch, a statistically significant(Student's t test, P < 0.05) decrease in heart rate, from a mean baseline of 88.6 (SD 7.31) beat min–1 to 51.3 (7.6) beatmin–1, occurred within 122.6 (16.9) s from the time of the EBP. Bradycardia was observed for a mean duration of 12.4 (1.1) s. Upper facial EMG, EEG, Sp02 and arterial pressure did not change.


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