Pulse-less Electrical Activity Provoked by Bezold-Jarisch Reflex during Lumbar Puncture for Spinal Anesthesia

Abstract

  We experienced a case in which pulse-less electrical activity occurred at the time of intrathecal drug injection. From a clinical standpoint, we considered that heart rate and blood pressure decreases were derived from the Bezold-Jarisch reflex, which was shown by heart rate variability analysis. Additionally, the pulse-less electrical activity might have been provoked because spinal anesthesia was performed without noticing the Bezold-Jarisch reflex. We concluded that it is important to check for the Bezold-Jarisch reflex emerging in patients in a sympathetically hypertonic state combined with a decrease in circulation volume.