Cardiac Arrest Due to Severe Vasovagal Response After Spinal Anaesthesia in Caesarean Section: Case Report

Introduction and importance: The vasovagal response is a reflex action that causes cardiovascular depression, bradycardia, and loss of consciousness. It is important to be aware of the risk factors for the vasovagal response and the pathophysiology that must be managed once it occurs. Case presentation: A 28-year-old mother was admitted to Ambo University Hospital for an emergency cesarean section. She received spinal anesthesia with bupivacaine 12.5 milligrams isobaric, and after the T4 blockade was reached, surgery was initiated. A few seconds later, the patient's heart rate, consciousness, oxygen saturation, and blood pressure dropped then immediately cardiopulmonary resuscitation was started adrenaline and fluid was administered. After a few minutes, the patient's vital signs recovered. And with careful monitoring in the intensive care unit for 24 hours, the patient was discharged to the obstetrics department and discharged to her home 2 days later without leaving any specific sequelae. This case demonstrates the potentially serious risk of vasovagal damage with spinal anesthesia during cesarean section, particularly during placental expulsion. Discussion: Vasovagal response secondary to spinal anesthesia and uterine retraction is a rare phenomenon, which results in a decrease in patient consciousness, heart rate oxygen saturation, blood pressure, and finally cardiac arrest. So it is important to know warning signs of the reflex and the early beginning of recitations. Conclusion: The unanticipated vasovagal response is secondary to spinal anesthesia and uterine retraction can potentially cause severe consequences. Therefore, the lessons we learned from this case were careful history-taking and preoperative evaluation; proper management of preload, early recognition of vasovagal responses through careful monitoring, and timely treatment of hemodynamic collapse.