[Pulmonary embolism was suspected during hip surgery under spinal anesthesia: a case report].

Most of the lower leg surgeries are done under spinal anesthesia. This 53 year old male had undergone a surgery for his left hip fracture previously and was scheduled for the removal of the screw. Spinal anesthesia was administered and sensory block was obtained up to T8. After the removal of the screw, he coughed weakly for several times. Suddenly ECG monitor showed severe bradycardia and hypotension was observed. He complained of chest pain, dyspnoea and went into shock. Immediately after giving atropine 0.5 mg iv, ephedrine 8 mg x 2 was necessary to raise his heart rate. About 3 minutes later he recovered from his shock state. ECG changes were transient and the bradyarrhythmia during his shock turned out to be AV dissociation. Arterial blood gas analysis showed decreased PaO2 and increased PaCo2. We suspected lung embolism. However, postoperative chest X-ray and pulmonary perfusion scans were within normal limits.