Aftershock: Asystole During Intubation in a Patient With Spinal Shock

Document Type

Conference Proceeding - Restricted Access

Publication Date



We present the case of a 47-year-old man who suffered a rollover motor vehicle accident and presented with multiple cervicothoracic vertebral fractures, most notably a C1 Jefferson fracture complicated by lower extremity paralysis. Spinal shock was diagnosed given the patient’s severe bradycardia and hypotension unresponsive to resuscitation. After several days, anesthesia was induced for odontoid screw fixation and upon laryngoscopy, the patient developed asystole. We will discuss the pathophysiology of spinal shock and its implications on anesthesia and acute care management.


American Society of Anesthesiology Annual Meeting, San Diego, CA, October 8-12, 2021.