2020 Volume 40 Issue 3 Pages 277-283
Cardiac arrest is the most serious complication during spinal anesthesia. Between 1945 and 2000, several hundred patients including many children and adolescents died due to high spinal anesthesia in Japan. These deaths were attributed either to the patient’s general physical condition or to the poor quality of the local anesthetics used. In my 1999 book Deaths During Spinal Anesthesia in Japan, I explain that the true cause of such deaths is the lack of careful observation of patients during and after spinal anesthesia. It was a strong warning to non-anesthesiologist physicians who administer spinal anesthesia. Since that time, the number of deaths has declined dramatically. Complications can be avoided by discarding the assumption that your patient is not at risk for cardiac arrest, and by observing your patient for at least two hours after spinal anesthesia.
