Anesth Pain Med.
2014 Jul;9(3):205-208.
Cardiac arrest following reversal of muscle relaxation by pyridostigmine: A case report
- Affiliations
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- 1Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. swkoo@amc.seoul.kr
- 2Department of Anesthesiology and Pain Medicine, Hallym University College of Medicine, Seoul, Korea.
Abstract
- The anticholinesterase pyridostigmine is usually used as a reversal agent of non-depolarizing muscle relaxants in general anesthesia. Most adverse muscarinic effects of anticholinesterases are controlled by anticholinergics; however, there is still a potential for fatal cardiac complications. We report a case of cardiac arrest associated with coronary vasospasm that developed during emergence from general anesthesia in a 61-year-old male patient undergoing uvulopalatopharyngoplasty with preoperatively undiagnosed coronary vasospastic angina. Anticholinesterases should be administered with caution for neuromuscular blockade reversal, especially in patients with coronary vasospastic angina.
MeSH Terms
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Anesthesia, General
Cholinergic Agents
Cholinergic Antagonists
Cholinesterase Inhibitors
Coronary Vasospasm
Heart Arrest*
Humans
Male
Middle Aged
Muscle Relaxation*
Neuromuscular Blockade
Neuromuscular Nondepolarizing Agents
Pyridostigmine Bromide*
Cholinergic Agents
Cholinergic Antagonists
Cholinesterase Inhibitors
Neuromuscular Nondepolarizing Agents
Pyridostigmine Bromide
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