Chung MY, Shin MJ, Cha SH, Lee JY. Transient asystole during balloon dilation of the Eustachian tube: A case report.
Medicine (Baltimore) 2022;
101:e31720. [PMID:
36343080 PMCID:
PMC9646581 DOI:
10.1097/md.0000000000031720]
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Abstract
RATIONALE
Neurally mediated reflexes can induce cardiac arrest during head and neck surgery through mechanisms including direct vagal stimulation, trigeminocardiac reflex, and baroreceptor reflex. Balloon dilation of the Eustachian tube (BDET) is a safe procedure without serious complications, including cardiac arrest.
PATIENT CONCERNS
Transient asystole developed during BDET under general anesthesia in a 33-year-old woman as soon as the balloon in the Eustachian tube (ET) was inflated.
DIAGNOSES
Monitoring records were reviewed. The asystolic period was recorded on the patient monitor as an event, which we recalled and printed. The asystole lasted for 13 seconds.
INTERVENTIONS
The patient recovered sinus rhythm spontaneously after the balloon was deflated before resuscitation. The BDET was successfully performed after prophylaxis with vagolytic drugs.
OUTCOMES
The patient recovered uneventfully after anesthesia.
LESSONS
BDET, previously known to be a relatively safe procedure, induces asystole via balloon dilation. It is thought to be a neurally mediated vagal reflex, and both anesthesiologists and otologic physicians should pay proper attention to monitoring during the procedure.
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