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British Journal of Anaesthesia, 2002, Vol. 89, No. 3 519-523
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Case Reports

Coronary artery spasm and non-Q-wave myocardial infarction following intravenous ephedrine in two healthy women under spinal anaesthesia

A. Wahl1, F. R. Eberli1, D. A. Thomson2 and M. Luginbühl*,2

1 Cardiology, Swiss Cardiovascular Centre and 2 Department of Anaesthesiology, University Hospital of Bern, CH-3010 Bern, Switzerland *Corresponding author

Vasovagal episodes occur frequently in young healthy patients undergoing venous cannulation and loco-regional anaesthesia. We report two cases of severe coronary vasospasm and non-Q-wave infarction in healthy young women after administration of ephedrine for vasovagal symptoms at the onset of spinal anaesthesia. In the light of unopposed vagal predominance predisposing patients to coronary vasospasm, even in young healthy patients, atrophine and not ephedrine should be the first line treatment for bradycardia with or without hypotension under spinal anaesthesia.

Br J Anaesth 2002; 88: 519–23


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