Asystole during manipulation with a curved-blade laryngoscope and tracheal intubation in patient with a history of syncope: A case report

ABSTRACT

Vagal reflex during manipulation with a curved-blade laryngoscope and tracheal intubation may result in severe bradycardia and even, asystole. Manipulation with laryngoscope and tracheal intubation leaded to bradycardia and asystole at a 47-year-old woman during induction of anesthesia with propofol, remifentanil and cisatracurium and sevoflurane inhalation. Withdrawal of laryngoscope and atropine 0.5 mg injection, her heart rate was recovered to normal sinus rhythm. Intubation at secondary trial was done with bradycardia and heart rate was returned to normal sinus rhythm soon. She had a history of syncope in interview after surgery and was examined tilt test to find of cause of syncope. Although the result of the test was negative, the bradycardia and asystole seemed to be caused by vagal reflex.