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CASE REPORT

Asystole due to vagal reflex in a patient with obstructive sleep apnea during anesthesia intubation with laryngoscope


1 Department of Anesthesiology, National Defense Medical Centre, Tri-Service General Hospital, Taoyuan, Taiwan
2 Division of Pediatric General Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine; Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taoyuan, Taiwan

Correspondence Address:
Go-Shine Huang,
Department of Anesthesiology, National Defense Medical Centre, Tri-Service General Hospital, Taipei
Taiwan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmedsci.jmedsci_220_21

Obstructive sleep apnea (OSA) is a serious sleep disorder. The complications of OSA are respiratory and cardiovascular events, including bradycardia, tachycardia, and even cardiac arrest. A 57-year-old female with OSA was vulnerable to vagal stimulation, developing severe bradycardia and asystole during general anesthesia while undergoing intubation with a conventional direct laryngoscope. This asystole case highlights the fact that anesthetized patients with OSA may experience increased parasympathetic activity (vagal tone) and vagal stimulation with consequent severe bradycardia and asystole. Atropine is recommended to resolve such conditions.


 

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