Hyperventilation syndrome (HVS) often occurs under stressful conditions, and has been reported during or after
anesthesia and operation. HVS, characterized by multiple
somatic symptoms and
electrolyte imbalances induced by inappropriate
hyperventilation, should be managed as an emergency. We report a rare case of HVS during
spinal anesthesia. The patient was a previously healthy 51-year-old female without psychogenic conditions. During
spinal anesthesia for lower extremity surgery, the patient complained of
nausea,
headache,
paresthesia in the upper extremities and perioral
numbness. We found carpal
spasm in both hands and flattening of T wave on electrocardiogram (ECG). Emergent arterial blood gas analysis (ABGA) revealed markedly decreased PaCO(2),
hypocalcemia and
hypokalemia. We managed the patient with verbal sedation,
electrolytes replacement
therapy and closed mask inhalation. HVS subsided gradually. We conclude that monitoring for possible HVS during
anesthesia is very important for patient safety.