Spinal anesthesia associated with reversal of myocardial ischemia.

Vasodilation is a means of reducing myocardial oxygen consumption; it is widely employed in the management of angina pectoris (1). Spinal anesthesia is well-recognized as a form of anesthesia that produces both arteriolar and venodilation due to sympathetic blockade (2). Furthermore, in the patient with coronary artery disease who is experiencing pain, the profound analgesia provided by conduction anesthesia may modulate the release of endogenous catecholamines and, therefore, indirectly reduce myocardial oxygen demand. We present a case where spinal anesthesia was associated with reversal of ST-segment depression in a patient with coronary artery disease.

[1]  R. Gray,et al.  Myocardial and systemic effects of nitroglycerin, given awake and during anaesthesia in coronary patients , 1983, Canadian Anaesthetists' Society journal.

[2]  N. M. Greene.  Preganglionic Sympathetic Blockade in Man: A Study of Spinal Anesthesia , 1981, Acta anaesthesiologica Scandinavica.

[3]  S. Reiz,et al.  Myocardial Oxygen Consumption and Coronary Haemodynamics during Fentanyl‐Droperidol‐Nitrous Oxide Anaesthesia in Patients with Ischaemic Heart Disease , 1981, Acta anaesthesiologica Scandinavica.

[4]  S. Reiz,et al.  Effects of Thoracic Epidural Block and Prenalterol on Coronary Vascular Resistance and Myocardial Metabolism in Patients with Coronary Artery Disease , 1980, Acta anaesthesiologica Scandinavica.

[5]  B. Gilbert,et al.  Myocardial ischemia during non-cardiac surgical procedures in patients with coronary-artery disease. , 1979 .

[6]  T. Ports,et al.  Rate-Pressure Product and Myocardial Oxygen Consumption during Surgery for Coronary Artery Bypass , 1979, Circulation.

[7]  W. Hamilton.  Editorial: Do let the blood pressure drop and do use myocardial depressants! , 1976, Anesthesiology.

[8]  G. Diamond,et al.  Medical therapy of acute myocardial infarction by application of hemodynamic subsets (second of two parts). , 1976, The New England journal of medicine.

[9]  F. Estafanous,et al.  Propranolol and cardiac surgery. , 1972, The Journal of thoracic and cardiovascular surgery.

[10]  R. Ward,et al.  Experimental evaluation of Atropine and Vasopressors for the Treatment of Hypotension of High Subarachnoid Anesthesia , 1966, Anesthesia and Analgesia.

[11]  Kenneth E. Bell.  Epidural and subarachnoid anesthesia , 1966 .