Asystole Following Profound Vagal Stimulation During Hepatectomy

• Main Authors: Preeta John, S Raj, Kartikeyan, Tony T Chandy
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2008-01-01
• Series: Indian Journal of Anaesthesia
• Subjects: Asystole; Hepatectomy; Peritoneal stimulus
• Online Access: http://www.ijaweb.org/article.asp?issn=0019-5049;year=2008;volume=52;issue=1;spage=81;epage=81;aulast=John

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 The anterior abdominal wall was retracted forty minutes after administration of the epidural bolus.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.