Progression of first degree heart block to high-grade second degree block during spinal anaesthesia

Abstract

A case is presented in which a patient with pre-existing first degree heart block developed high-grade second degree heart block during spinal anaesthesia. Progression of the block was associated with blockade of cardiac sympathetic neurons induced by spinal anaesthesia. This suggests that patients with pre-existing heart block may be at increased risk for development of higher grade block during spinal anaesthesia. © 1992 Canadian Anesthesiologists.