| Severe bradycardia and transient asystole during epidural anesthesia: A case report. |
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Soon Eun Park, Dae Young Kim, Hee Won Son, Daewoo Kim, Chul Ho Shin |
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Department of Anesthesiology and Pain Medicine, Ulsan University Hospital, Ulsan, Korea. kdyangel@naver.com |
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| Abstract |
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The severe bradycardia and asystole are uncommon complications of epidural anesthesia but can be life threatening if not managed properly. A 73-year-old, ASA class 3, male patient was admitted for a total knee replacement under epidural anesthesia. Approximately 10 minutes after epidural anesthesia, the heart rate decreased significantly to 20 beats/min with asystole. The heart rate returned to 80 beats/min after administering atropine, ephedrine, and external cardiac compression. Severe bradycardia and asystole may be induced by vagal activation as a result of the low venous return and sympathetic blockade. |
| Key Words:
asystole; bradycardia; epidural anesthesia; vagal activation |
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