title: Postinduction Paced Pulseless Electrical Activity in a Patient With a History of Oropharyngeal Instrumentation-Induced Reflex Circulatory Collapse.
abstract: BACKGROUND
  Reflex hypotension and bradycardia have been reported to occur following administration of several drugs associated with administration of anesthesia and also following a variety of procedural stimuli.
  
  
  METHODS
  A 54-year-old postmenopausal female with a history of asystole associated with sedated upper gastrointestinal endoscopy and post-anesthetic-induction tracheal intubation received advanced cardiac resuscitation after insertion of a temporary transvenous pacemaker failed to prevent pulseless electrical activity. The patient's condition stabilized, and she underwent successful cataract extraction, intraocular lens implantation, and pars plana vitrectomy.
  
  
  CONCLUSIONS
  Cardiac pacemaker insertion prior to performance of a procedure historically associated with reflex circulatory collapse can be expected to protect a patient from bradycardia but not necessarily hypotension.
authors.affiliation: Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Kline
authors.affiliation: Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA.
authors.forename: Ky
authors.initials: K
authors.lastname: Pham
authors.affiliation: Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA.
authors.forename: Carmen L
authors.initials: CL
authors.lastname: Labrie-Brown
authors.affiliation: Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA.
authors.forename: Ken
authors.initials: K
authors.lastname: Mancuso
authors.affiliation: Department of Internal Medicine, Louisiana State University Health Sciences Center, New Orleans, LA.
authors.forename: Paul
authors.initials: P
authors.lastname: LeLorier
authors.affiliation: Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA.
authors.forename: James
authors.initials: J
authors.lastname: Riopelle
authors.affiliation: Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA.
authors.forename: Alan David
authors.initials: AD
authors.lastname: Kaye
keywords: Anesthesia–general; heart arrest; pacemaker–artificial; shock