Low Heart rate after epidural?

[borka]

Hello. I had a patient who got an epidural and her BP stayed in 100-110/70-80s, but her heart rate suddenly drop from 80s to 50s...it was not connected to BP drop and although BP would go up after a 5mg of Ephedrine, her HR will still stay in low 50s. She felt light headed and just "out of it"...Anyone else experienced this before?

[l/dmom]

We actually had the opposite happen. Two patients in the last two weeks had gotten an epidural and their heart rate went up to the 100 to 120's. The first time an ekg was done and cardiac monitoring with no real diagnosis. Still a mystery. Did she ever turn the corner?

[SmilingBluEyes]

Did the MDA/CRNA hit a blood vessel in the placement/administration of meds in the epidural procedure?

[nocturnalnurse]

Both bradycardia and tachycardia are known possible side effects of epidural anesthesia. I have seen both. epidural placement particularily at the L2-L3 location block sympethetic outflow to nerves that effect vasomotor nerve fibers that can effect the tone of the muscular wall of arteries and veins-which in turn effects blood pressure and heart rate/cardiac output. It is much more complicated than that and there are other systems that get involved and other reflexes that can be triggered by this sort of anesthesia but the gist of it is that it can happen and you should be aware of it. I had one that got bradycardic enough to need anesthesia to stay at the bedside until the effects wore off. I had another one get tachycardic enough that the anesthesiaologist had to stay at the bedside and push esmolol over and over again until it got better.