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Korean J Anesthesiol > Volume 46(6); 2004 > Article
Korean Journal of Anesthesiology 2004;46(6):729-734.
DOI: https://doi.org/10.4097/kjae.2004.46.6.729   
Pulmonary Embolism after Spinal Anesthesia Induction for the Surgical Reduction of a Femur Neck Fracture: A case report.
Jong Deok Park, Jun Yong In, Myong Ae Lee, Ho Sung Kwak
Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul, Korea.
This case involved a pulmonary thromboembolism, which originated from the lower extremity. A 68-year-old female, with a femur neck fracture, underwent spinal anesthesia with 0.5% heavy bupivacaine 11 mg for total hip arthroplasty. Ten minutes after the induction of spinal anesthesia, dyspnea, tachycardia and hypotension appeared. Under the impression of a pulmonary embolism, intubation was done and dopamine and epinephrine were infused. The operation stopped and she was sent to the intensive care unit. On the spiral CT chest angiogram, a pulmonary embolism was found. Deep venous thrombosis was detected in the left lower extremity on the venogram. Heparin therapy was started at a rate of 800 U/hour with a bolus of 5000 U. A consultative operation for the removal of deep vein thrombosis was performed by a chest surgeon, and total hip arthroplasty was performed successfully under spinal anesthesia.
Key Words: deep venous thrombosis; femur neck fracture; pulmonary embolism; spinal anesthesia
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