Perioperative cardiac arrest in the operating room environment: a review of the literature

Hinkelbein, Jochen; Andres, Janusz; Thies, Karl-Christian; Robertis, Edoardo De

doi:10.23736/s0375-9393.17.11802-x

Cited by 33 publications

(22 citation statements)

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“…PEA may be a challenging diagnosis and integration of several monitored parameters may be the key not to delaying the diagnosis [ 1 ]. Monitoring rSO2 has been previously described as a feasible tool during resuscitation as it can lead to earlier detection of CA and ROSC [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

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Cardiac Arrest During Spinal Surgery: A Multidisciplinary Approach and Management of Takotsubo Syndrome

Silva¹,

Carrillo-Alfonso²,

Amorim³

2022

Cureus

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Cardiac arrest (CA) in the operating room is rare. Among known perioperative CA causes, Takotsubo syndrome (TTS) is a well-recognized one. Perioperative TTS is more common than existing reported cases therefore anesthesiologists should be aware of its diagnosis and management. TTS is an acquired and selflimited stress cardiomyopathy usually triggered by a precipitating stress factor and should be considered in any hospitalized patient presenting with symptoms such as acute coronary syndrome, cardiac arrhythmias or CA. A 67-year-old woman presented for lumbar discectomy in knee-chest position suffered CA two hours after the beginning of surgery. After a thorough examination, TTS was determined as the cause. This case report highlights the importance of TTS as a differential diagnosis of CA in the intraoperative setting as well as the usefulness of multimodal monitoring with cerebral monitoring to assist the prompt pulseless electric activity diagnosis. To our knowledge, this is the first case report in such circumstances.

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Section: Discussionmentioning

confidence: 99%

“…Cardiac arrest (CA) in the operating room is a rare and potentially fatal event [ 1 ]. Among known perioperative CA causes, Takotsubo syndrome (TTS) is a well-recognized one [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Cardiac Arrest During Spinal Surgery: A Multidisciplinary Approach and Management of Takotsubo Syndrome

Silva¹,

Carrillo-Alfonso²,

Amorim³

2022

Cureus

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“…The perioperative serious electrocardiographic changes may be originated by a relative imbalance of autonomic activities due to excessive psychosomatic stress during dental care, or anesthetic and surgical procedures. 1 – 3 This study case shows a rare and unusual situation of the transient asystole as a serious sign of vasovagal reflex (VVR) likely to be triggered by venipuncture for peripheral intravenous access placement during anticipatory dental anxiety. On the best of our knowledge, there is no report regarding the management of intravenous sedation (IVS) during dental care in a dental phobic patient with the occurrence of asystole.…”

Section: Introductionmentioning

confidence: 94%

Transient asystole associated with vasovagal reflex in an oral surgery patient: A case report

Shimoda

Yamauchi

Takahashi

2023

SAGE Open Medical Case Reports

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The perioperative cardiac events may be brought about by a relative imbalance of autonomic activities due to excessive psychological and physical stress. The present case study focuses on the asystole that can occur as a serious cardiac adverse event associated with vasovagal reflex likely to be triggered by venipuncture for securing an intravenous line during dental care. In addition, we describe and discuss herein the management of intravenous sedation for a dental phobic patient who experienced the vasovagal reflex involved in an unexpected transient asystole. The patient with vasovagal reflex episodes in daily life, who had no past medical history relevant to cardiovascular disorders, was scheduled for dental extraction under intravenous sedation. Immediately after peripheral intravenous catheterization, she complained of discomfort and nausea, and a II-lead electrocardiogram revealed asystole following bradycardia associated with vasovagal reflex. Oxygenation and intravenous fluid loading in the supine position with elevation of the lower extremities restored sinus rhythm and normal hemodynamics without the intervention of cardiopulmonary resuscitation. With administration of intravenous atropine and betamethasone as premedication, she was uneventfully treated in stress-free psychosomatic conditions under optimal sedation with midazolam without any signs of cardiovascular disorders. After administration of flumazenil, the patient satisfactorily recovered from sedation without re-sedation. The present case suggests that an asystole associated with vasovagal reflex can be triggered by venipuncture for intravenous catheterization during dental anxiety likely to affect the imbalance between sympathetic and parasympathetic activities.

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“…Similarly, although it is difficult to anticipate the further development of anaesthesiology and intensive care, this does not mean that visions of such developments do not exist, as I will discuss later in this article. Surprising observations made in the above-quoted publications [14][15][16], as well as current data on the occurrence of perioperative cardiac arrest in non-cardiac surgery (about 1 case of cardiac arrest per 10,000 anaesthetic procedures in adults and 3-4 times more in children [17]) indicate the need to modify the standard of practice in the perioperative period, both in terms of eligibility for surgery, adequate monitoring and the prevention of complications, as well as to elaborate clinically useful recommendations along with guidelines in the field of ethics. The elaboration of any subsequent recommendations for practice should, however, take into account the realities of health systems and be based on the need to adapt to local conditions while respecting the doctor-patient relationship and maintaining patient's autonomy [18].…”

Section: Janusz Andresmentioning

confidence: 99%

Perioperative cardiac arrest in the operating room environment: a review of the literature

Cited by 33 publications

References 0 publications

Cardiac Arrest During Spinal Surgery: A Multidisciplinary Approach and Management of Takotsubo Syndrome

Cardiac Arrest During Spinal Surgery: A Multidisciplinary Approach and Management of Takotsubo Syndrome

Transient asystole associated with vasovagal reflex in an oral surgery patient: A case report

Rola anestezjologii i intensywnej terapii w zapewnieniu bezpieczeństwa pacjenta w okresie okołooperacyjnym: przeszłość, teraźniejszość i przyszłość

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