Korean J Anesthesiol.  1994 May;27(5):503-508. 10.4097/kjae.1994.27.5.503.

A Case of Sudden Hypotension Following Intraoperative Intercostal Nerve Block

• Song JJ
• Lee SK
• Kuh JH
• Song HS

• KMID: 1752561
• DOI: http://doi.org/10.4097/kjae.1994.27.5.503

Abstract

Postoperative pain may be associated with shallow breathing, inability to cough, and reduction in spirometric values which lead to restrictive pattern of ventilation with hypoxemia and/or hypercarbia. Therefore, postoperative pain should be managed with appropriate methods. The authors have usually performed intraoperative intercostal nerve block with 0.25% bupivacaine hydrochloride to alleviate postoperative thoracotomy pain. A 21 years old male patient developed sudden hypotension and severe bradycardia 1 minute following the intraoperative 4th, 5th, 6th intercostal nerve block with a total of 10 ml of 0.25% bupivacaine hydrochloride, who was treated by ephedrine with success. The authors discuss the possible causes of sudden hypotension and severe bradycardia in detail.

Keyword

Intercostal nerve block; Bupivacaine; Postoperative pain; Hypotension

MeSH Terms

Anoxia
Bradycardia
Bupivacaine
Cough
Ephedrine
Humans
Hypotension*
Intercostal Nerves*
Male
Pain, Postoperative
Respiration
Thoracotomy
Ventilation
Young Adult
Bupivacaine
Ephedrine