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Intraoperative arrhythmias occurs frequently during paediatric anaesthesia. Common causes include surgical stimulation under light anaesthesia, hypoxia and hypercarbia. We report an unusual case of ventricular fibrillation in a child during general anaesthesia, following tracheal intubation. Case reportThe patient was a seven-year-old white male scheduled for hypospadias revision. The initial hypospadia repair, two years previously under general anaesthesia had been without anaesthetic complications. The patient had no significant past medical history, no history of allergies, and currently was receiving no medications. Physical examination revealed a well developed boy with a blood pressure of 110/70 mmHg and heart rate of 85 (regular), who was afebrile and weighed 26 kg. The patient had normal first and second heart sounds with no murmurs, gallops, or rubs. The remainder of the physical examination was normal. Laboratory studies were within normal limits.Since the patient was admitted on the day of surgery no premedication had been given. The patient was monitored with an EKG, a doppler for blood pressure measurement, and a precordial stethoscope. Mask induction with 02, N20, and halothane was performed. A 20 gauge 1V was then started and a rectal temperature probe inserted. The patient at this time was given 0.5 mg.kg -~ atracurium to facilitate tracheal intubation. The EKG showed a normal sinus rhythm and there was minimal decrease of blood pressure. Just prior to laryngoscopy, however, the patient' s EKG changed to a nodal rhythm with a rate of 74, and occasional CAN ANAESTH SOC J 1986 / 33:6 / pp795-8

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