Delayed Cardiac Arrest after Brachial Plexus Block in a Patient Taking a beta-Adrenoreceptor Antagonist and Calcium Channel Blocker: A case report.
10.4097/kjae.2006.51.6.752
- Author:
Jong Yeon LEE
1
;
Hyung Suk LEE
;
Sa Hyun PARK
;
Hyun Jue GILL
;
Sang Woo LEE
;
Seung Ho KIM
;
Kuem Hee CHUNG
;
Min Sung KIM
;
Heon Rak LEE
Author Information
1. Department of Anesthesiology and Pain Medicine, Pochon CHA University College of Medicine, Pocheon, Korea. gill5432@naver.com
- Publication Type:Case Report
- Keywords:
beta-adrenoreceptor antagonist;
brachial plexus block;
calcium channel blocker;
cardiac arrest;
vasovagal syncope
- MeSH:
Anesthetics;
Autonomic Nervous System;
Brachial Plexus*;
Calcium Channels*;
Calcium*;
Epinephrine;
Female;
Heart Arrest*;
Humans;
Humerus;
Hypertension;
Middle Aged;
Peripheral Nerves;
Reflex;
Respiration;
Syncope, Vasovagal
- From:Korean Journal of Anesthesiology
2006;51(6):752-755
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
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.
