Cardiac arrest in a child during a combined general epidural anesthesia procedure
Keywords:
Cardiac arrest, child, combined general epidural anesthesia procedure
Abstract
An increased risk of perioperative cardiac arrestin children, in comparison to adults, has been
recognized. A number of factors associated
with perioperative cardiac arrest have been identified,
including young age, comorbidities, and emergency
surgery. Since anesthesia-related cardiac arrest is
uncommon, a multi-related database is required to
understand the mechanisms of cardiac arrest and to
develop preventive strategies. Most cardiac arrests
occur during induction (37%) or maintenance (45%)
of anesthesia, usually following one or more of the
following antecedent events, i.e., bradycardia (54%),
hypotension (49%), abnormality of oxygen saturation
as measured by pulse oximetry (48%), inability to
measure blood pressure (25%), abnormality of end-
tidal CO 2 (21%), cyanosis (21%), or arrhythmia
(18%). In 11% of cases, cardiac arrest occurred
without recognized warning. There are only few
reports in the literature, and in Kariadi Hospital, none
has ever been reported. The aim of this report is to
identify and discuss possible causes of cardiac arrest
and to anticipate its complications.
References
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cardiac arrest during the insertion of an epidural cath-
eter and before the administration of epidural medica-
tion. Anesth Analg 1998;86:1263-65.
7. Zideman DA. Resuscitation. Br J Anaesth 1999; 83:
157-68.
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gional anesthesia in children. Br J Anaesth 1999;83:65-
77.
9. Roelants F, Veyckemans F, Van Obbergh L, Singelyn F,
Waterloos H, Gribomont BF. Loss of resistance to sa-
line with bubble of air to identify the epidural space in
infants and children. Anesth Analg 2000;90:59-61.
10. Keats AS. The role of anesthesia in surgical mortality.
In: Gravenstein N, editor. Complication in anesthesi-
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11. Stoelting RK. Inhaled Anesthetics. In: Stoelting RK,
editor. Pharmacology and physiology in anasthetic prac-
tice. 2nd ed. Philadelphia: Lippincott Raven; 1991. p.
33-69.
12. Stoelting RK. Nonbarbiturate induction drugs. In:
Stoelting RK, editor. Pharmacology and physiology in
anasthetic practice. 2nd ed. Philadelphia: Lippincott
Raven; 1991. p. 134-47.
13. Collins VJ. Fluids and electrolytes. In: Collins VJ, edi-
tor. Physiology and pharmacology based of anesthe-
sia. Philadelphia: Williams and Wilkins; 1996. p. 165-
87.
CM, Hackel A, Caplan RA, et al. Anesthesia-related
cardiac arrest in children: Initial findings of the Pediat-
ric Perioperative Cardiac Arrest (POCA) Registry. An-
esthesiology 2000; 93:6-14.
2. Moritz HA, Parnass SM, Mitchell JS. Ventricular fi-
brillation during anesthetic induction in a child with
undiagnosed mitral valve prolapse. Anesth Analg
1997;85:59-61.
3. Curatolo M, Scaramozzino P, Venuti FS, Orlando A,
Zbinden AM. Factors associated with hypotension and
bradycardia after epidural blockade. Anesth Analg
1996;83:1033-40.
4. Gabbott DA, Baskett PJF. Management of the airway
and ventilation during resuscitation. Br J Anaesth
1997;79:159-71.
5. Zideman DA. Pediatric and neonatal life support. Br J
Anaesth 1997;79:178-87.
6. Sprung J, Abdelmalak B, Schoenwald PK. Vasovagal
cardiac arrest during the insertion of an epidural cath-
eter and before the administration of epidural medica-
tion. Anesth Analg 1998;86:1263-65.
7. Zideman DA. Resuscitation. Br J Anaesth 1999; 83:
157-68.
8. Brown TCK, Eyres RL, McDougall RJ. Local and re-
gional anesthesia in children. Br J Anaesth 1999;83:65-
77.
9. Roelants F, Veyckemans F, Van Obbergh L, Singelyn F,
Waterloos H, Gribomont BF. Loss of resistance to sa-
line with bubble of air to identify the epidural space in
infants and children. Anesth Analg 2000;90:59-61.
10. Keats AS. The role of anesthesia in surgical mortality.
In: Gravenstein N, editor. Complication in anesthesi-
ology. 2nd ed. Philadelphia: Lippincott Raven; 1996.
p. 27-36.
11. Stoelting RK. Inhaled Anesthetics. In: Stoelting RK,
editor. Pharmacology and physiology in anasthetic prac-
tice. 2nd ed. Philadelphia: Lippincott Raven; 1991. p.
33-69.
12. Stoelting RK. Nonbarbiturate induction drugs. In:
Stoelting RK, editor. Pharmacology and physiology in
anasthetic practice. 2nd ed. Philadelphia: Lippincott
Raven; 1991. p. 134-47.
13. Collins VJ. Fluids and electrolytes. In: Collins VJ, edi-
tor. Physiology and pharmacology based of anesthe-
sia. Philadelphia: Williams and Wilkins; 1996. p. 165-
87.
Published
2016-10-10
How to Cite
1.
Soenarjo S, Prabakti Y, Siahaan E, Soemantri A, Sidhartani M. Cardiac arrest in a child during a combined general epidural anesthesia procedure. PI [Internet]. 10Oct.2016 [cited 16Apr.2024];45(3):132-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/819
Section
Case Report
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Received 2016-10-06
Accepted 2016-10-06
Published 2016-10-10
Accepted 2016-10-06
Published 2016-10-10
