| Delayed Cardiac Arrest after Brachial Plexus Block in a Patient Taking a beta-Adrenoreceptor Antagonist and Calcium Channel Blocker: A case report. |
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Jong Yeon Lee, Hyung Suk Lee, Sa Hyun Park, Hyun Jue Gill, Sang Woo Lee, Seung Ho Kim, Kuem Hee Chung, Min Sung Kim, Heon Rak Lee |
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Department of Anesthesiology and Pain Medicine, Pochon CHA University College of Medicine, Pocheon, Korea. gill5432@naver.com |
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| Abstract |
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A Bezold-Jarisch reflex (BJR) mediated vasovagal syncope is the most common neurally mediated reflex characterized by the sudden failure of the autonomic nervous system and have been reported in patients undergoing a peripheral nerve block. The concomitant administration of a beta-adrenoreceptor antagonist and calcium channel blocker have a synergistic suppressant effect on the autonomic nervous system and interact with the anesthetics significantly. We report a case of a 57-year-old female patient with essential hypertension controlled with lercanidipine and carvedilol. Cardiac arrest developed with spontaneous respiration 50 min after the brachial plexus block to remove a plate in the humerus. Epinephrine was administered and the pulse immediately returned to a normal sinus rhythm. This event might be vasovagal syncope mediated by BJR, and realted to the antihypertensive medication used. |
| Key Words:
beta-adrenoreceptor antagonist; brachial plexus block; calcium channel blocker; cardiac arrest; vasovagal syncope |
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