Vancomycin reaction during spinal anaesthesia

Abstract

A 77-year-old female received unevenful spinal anaesthesia for a total knee replacement. Upon the advice of the microbiologists and at the request of the orthopaedic surgeon, a vancomycin infusion was commenced prior to the application of the leg tourniquet. Five minutes later, having received only 40 mg of the antibiotic dose, she became unconscious and suffered severe cardiovascular collapse, from which she was resuscitated with intravenous ephedrine and adrenaline.