[Bradycardia and cardiac asystole immediately after abdominal incision for removal of a huge pyometra].
We report a patient who developed cardiac asystole, which may have been caused by Bezold-Jarisch reflex as a result of hypovolemia and compression of the inferior vena cava by a huge pyometra. A 61-year-old woman with a huge pyometra with occasional supine hypotension, tachycardia, and oliguria was scheduled for removal of the tumor. The systolic blood pressure decreased from 80 mmHg to 55 mmHg with simultaneous development of bradycardia 5 minutes after incision of the abdominal wall. Atropine was given but cardiac asystole occurred. Intravenous epinephrine restored systemic blood pressure and heart beats. There was no postoperative cardiorespiratory complication.
Iihoshi
Mari
M
Department of Anesthesiology, Federation of National Public Service Personnel Mutual Aid Associations, Chihaya Hospital, Fukuoka 813-8501.
Kato
Megumi
M
Higa
Kazuo
K
Ikeda
Mayumi
M
D001919:Bradycardia / Q000209:etiology*; D005260:Female; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D013492:Suppuration; D014591:Uterine Diseases / Q000601:surgery*; D014682:Vena Cava, Inferior