Heart block following propofol in a child.
We present the case of a nine-year-old boy afflicted with Ondine's curse, who developed complete atrioventricular heart block after a single bolus of propofol for induction of anaesthesia for strabismus surgery. Ondine's curse, the other name for congenital central hypoventilation syndrome, is characterized by a generalized disorder of autonomic function. Propofol has no effect on the normal atrioventricular conduction system in humans but it reduces sympathetic activity and can highly potentiate other vagal stimulation factors. Heart block has been documented after propofol bolus use in adults but, to our knowledge, not in children. It would appear that propofol is not a good choice for anaesthesia in congenital central hypoventilation syndrome.
Clinic of Paediatric Anaesthesia, University Children's Hospital, Queen Fabiola, Brussels, Belgium.
C
C
Sochala
D
D
Deenen
A
A
Ville
M J
MJ
Govaerts
D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D001283:Atrioventricular Node / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D004562:Electrocardiography / Q000187:drug effects; D006327:Heart Block / Q000139:chemically induced*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage; D008297:Male; D009609:Nitrous Oxide / Q000008:administration & dosage; D010100:Oxygen / Q000008:administration & dosage; D015742:Propofol / Q000009:adverse effects*; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000503:physiopathology; D013285:Strabismus / Q000150:complications / Q000601:surgery; D013564:Sympathetic Nervous System / Q000187:drug effects; D014630:Vagus Nerve / Q000187:drug effects
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D007530:Isoflurane; D009609:Nitrous Oxide; D010100:Oxygen; D015742:Propofol