Ruptured Aortic Aneurysm and Cardiac Arrest Associated with Spinal Anesthesia

ALTHOUGH hemodynamic changes frequently occur during spinal anesthesia,' cardiac arrest during spinal anesthesia is extremely rare. 1-3 According to the closed claims analysis by Caplan et al., 4 cardiac arrest during spinal anesthesia usually resulted from hypoxemia and hypercarbia associated with unappreciated respiratory insufficiency. Cardiac arrest during spinal anesthesia also has been reported without hypoxemia or obvious respiratory depression in patients with sick sinus syndrome or due to vasovagal response. 5-8 However, there are no previous reports of cardiac arrest and ruptured abdominal aortic aneurysm (RAAA) associated with spinal anesthesia. We report a case of cardiac arrest and RAAA during spinal anesthesia and discuss the pathophysiologic changes associated with cardiac arrest after spinal anesthesia in context with RAAA.