Osaka city medical journal
-
Case Reports
Asystole developed during total gastrectomy under general anesthesia combined with thoracic epidural anesthesia.
We report a 73-year-old woman who developed sudden bradycardia and asystole due to vagal reflex during transabdominal total gastrectomy under general anesthesia with thoracic epidural analgesia. General anesthesia was induced with propofol, fentanyl and maintained with sevoflurane and epidural infusion of lidocaine. ⋯ Surgery was completed uneventfully and the patient was discharged without complications. For preventing life-threatening bradycardia and asystole by vagal reflex, we suggest the use of atropine prior to the operations in patients undergoing abdominal or ophthalmic surgery, where vagal reflex may occur.