Anesth Pain Med.  2012 Oct;7(4):325-328.

Asystole during manipulation with a curved-blade laryngoscope and tracheal intubation in patient with a history of syncope: A case report

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Presbyterian Medical Center, Jeonju, Korea. anes8838@lycos.co.kr

Abstract

Vagal reflex during manipulation with a curved-blade laryngoscope and tracheal intubation may result in severe bradycardia and even, asystole. Manipulation with laryngoscope and tracheal intubation leaded to bradycardia and asystole at a 47-year-old woman during induction of anesthesia with propofol, remifentanil and cisatracurium and sevoflurane inhalation. Withdrawal of laryngoscope and atropine 0.5 mg injection, her heart rate was recovered to normal sinus rhythm. Intubation at secondary trial was done with bradycardia and heart rate was returned to normal sinus rhythm soon. She had a history of syncope in interview after surgery and was examined tilt test to find of cause of syncope. Although the result of the test was negative, the bradycardia and asystole seemed to be caused by vagal reflex.

Keyword

Asystole; Bradycardia; Syncope; Tracheal intubation; Vagal reflex

MeSH Terms

Anesthesia
Atracurium
Atropine
Bradycardia
Female
Heart Arrest
Heart Rate
Humans
Inhalation
Intubation
Laryngoscopes
Methyl Ethers
Middle Aged
Piperidines
Propofol
Reflex
Syncope
Atracurium
Atropine
Methyl Ethers
Piperidines
Propofol
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