title: [Asystole after combination anesthesia].
abstract: A 55-year-old man with liver cancer underwent partial hepatectomy under combined lumbar epidural and general anesthesia. Asystole during postoperative recovery was followed by ventricular fibrillation. After unsuccessful cardiopulmonary resuscitation efforts, brain death was diagnosed. In the absence of anemia, acidosis, electrolytic alterations or hypothermia, and after ruling out hemoperitoneum, acute myocardial infarction and stroke, we conclude that the clinical picture described was the result of autonomic imbalance due to spreading of the sympathetic block.
mesh_terms: D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000769:Anesthesia, Inhalation / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects* / Q000493:pharmacokinetics; D001279:Atracurium; D001926:Brain Death; D002045:Bupivacaine / Q000009:adverse effects* / Q000493:pharmacokinetics; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D017558:Elective Surgical Procedures; D017809:Fatal Outcome; D005283:Fentanyl; D006323:Heart Arrest / Q000139:chemically induced* / Q000150:complications; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007530:Isoflurane; D008113:Liver Neoplasms / Q000601:surgery*; D008161:Lumbosacral Region; D008297:Male; D008874:Midazolam; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects; D011183:Postoperative Complications / Q000139:chemically induced*; D015742:Propofol; D012018:Reflex; D014693:Ventricular Fibrillation / Q000209:etiology*
chemical_list: D000779:Anesthetics, Local; D001279:Atracurium; D009020:Morphine; D007530:Isoflurane; D008874:Midazolam; D005283:Fentanyl; D002045:Bupivacaine; D015742:Propofol
vernacular_title: Asistolia después de anestesia combinada.