Comment on Published Article
Department of Anaesthesiology, Mahatma Gandhi Medical College, Sri Balaji Vidyapeeth University, Pondicherry, India
Address for correspondence: Dr. Divya Devanathan, Department of Anaesthesiology, Mahatma Gandhi Medical College, Sri Balaji Vidyapeeth University, Pondicherry, India. E-mail: [email protected]
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Dear Editor,
I read with interest the article titled ‘Hypertension and tachycardia following high spinal anaesthesia during lower segment caesarean section: An unusual presentation’.[1] It was a very well-managed case of high spinal anaesthesia. However, I would like to seek certain clarifications regarding the same.
The article makes no clear mention about the timeline of events and vitals during the event of hypotension. According to Parthasarathy,[2] in spontaneously breathing patients complaining of breathlessness we need to avoid closed breathing circuits as this would increase the work of breathing, which could have contributed to the cascade of events. Also, the article does not mention the flow used in this patient.
In this case, breathlessness is the only symptom suggestive of hypercarbia being mentioned. It would be interesting to know whether other signs of hypercarbia like headache, confusion, and flushing were present.[3] Also, the method by which hypercarbia was confirmed is not stated in the paper.
The article does not explain how other causes of hypertension and tachycardia, like drug error, anxiety, and intraoperative shivering, were ruled out in their case as they could explain the causal events better.
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Conflicts of interest
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REFERENCES
1. Chatterjee P, Senthilnathan M, Tenzing E. Hypertension and tachycardia following high spinal anaesthesia during lower segment caesarean section:An unusual presentation. Indian J Anaesth 2022;66:741–2.
2. Parthasarathy S. The closed circuit and the low flow systems. Indian J Anaesth 2013;57:516–24.
3. Duke J. Anesthesia Secrets 4
th ed Philadelphia, PA Mosby/Elsevier 2011 574.
