AI Article Synopsis
- Neurally mediated reflexes can cause cardiac arrest during head and neck surgery, but balloon dilation of the Eustachian tube (BDET) is generally safe and rarely leads to serious complications.
- A 33-year-old woman experienced transient asystole (13 seconds) during BDET when the balloon was inflated under general anesthesia.
- Following deflation of the balloon and the administration of vagolytic drugs, the patient returned to normal rhythm and recovered well after the procedure, highlighting the need for careful monitoring by both anesthesiologists and otolaryngologists.*
Article Abstract
Rationale: Neurally mediated reflexes can induce cardiac arrest during head and neck surgery through mechanisms including direct vagal stimulation, trigeminocardiac reflex, and baroreceptor reflex. Balloon dilation of the Eustachian tube (BDET) is a safe procedure without serious complications, including cardiac arrest.
Patient Concerns: Transient asystole developed during BDET under general anesthesia in a 33-year-old woman as soon as the balloon in the Eustachian tube (ET) was inflated.
Diagnoses: Monitoring records were reviewed. The asystolic period was recorded on the patient monitor as an event, which we recalled and printed. The asystole lasted for 13 seconds.
Interventions: The patient recovered sinus rhythm spontaneously after the balloon was deflated before resuscitation. The BDET was successfully performed after prophylaxis with vagolytic drugs.
Outcomes: The patient recovered uneventfully after anesthesia.
Lessons: BDET, previously known to be a relatively safe procedure, induces asystole via balloon dilation. It is thought to be a neurally mediated vagal reflex, and both anesthesiologists and otologic physicians should pay proper attention to monitoring during the procedure.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9646581 | PMC |
| http://dx.doi.org/10.1097/MD.0000000000031720 | DOI Listing |
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