Transient bradycardia associated with extradural blood patch after inadvertent dural puncture in parturients.

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) beat min-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, SpO2 and arterial pressure did not change.

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