Expert: Ronald Levy, M.D. - 11/14/2007

Question
My 71-year-old husband recently was scheduled for routine lower back surgery to remove bone spurs and relieve pressure on sciatic nerve.  He was to be administered general anesthesia.  Immediately upon start of administration and intubation, he suffered a "complete, catastrophic failure of the cardio and pulmonary systems". (his doctor's words).  CPR followed for 2-3 minutes with drugs administered to restart heart.  He never even made it to the operating table.  He was in ICU for 3 days and his heart is back to normal - breathing still compromised with COPD.  Tests were done while in ICU to determine if allergic to anesthesia.  Tests negative.  Cardiologist, anesthesiologist, nor general physician know what happened.  They say we may never know.  What is your opinion?  Where should I go from here?  What if he needs surgery?  Might the drugs have been administered too fast or too high dosage?  Your thoughts please.

Answer
There are a number of possible scenarios. Most likely he either had an arrythmia or too much medication but there is no way to really tell. Yes, he can have surgery in the future. The anesthesiologist will treat the case differently. Perhaps he'll use invasive monitoring (like an arterial line) or choose an anesthetic that is more cardiac stable. There is nothing for you to do right now but wait for him to recover.

Good Luck,

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston