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CASE REPORT
Year : 2008  |  Volume : 52  |  Issue : 1  |  Page : 81

Asystole Following Profound Vagal Stimulation During Hepatectomy


1 Lecturer, Department of Anesthesiology, Christian Medical College, Vellore, India
2 P.G. Resident, Department of Anesthesiology, Christian Medical College, Vellore, India
3 Senior Lecturer, Department of Anesthesiology, Christian Medical College, Vellore, India

Correspondence Address:
Preeta John
Department of Anesthesiology, Christian Medical College, Vellore, Tamil Nadu, Pin 632004.
India
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Source of Support: None, Conflict of Interest: None


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Asystole in a non laparoscopic upper abdominal surgery following intense vagal stimulation is a rare event. This case report highlights the need for awareness of such a complication when a thoracic epidural anaesthetic has been given in addition to a general anaesthetic for an upper abdominal procedure. A combined thoracic epidural and general anaesthetic was given. The anterior abdominal wall was retracted forty minutes after administration of the epidural bolus. This maneuver resulted in a profound vagal response with bradycardia and asystole. The patient was resuscitated successfully with a cardiac massage, atropine and adrenaline and the surgery was resumed. Surgery lasted eleven hours and was uneventful.


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