Intraoperative manifestation of sick sinus syndrome in an eight-month-old child

Sick sinus syndrome is characterized by a gradually progressive deficit in the function of the sinus node and may not manifest itself clinically for a long time. During anesthesia and/or surgery, it may first appear in the form of severe, atropine-refractory bradycardia or sudden asystole. The presented clinical case describes the intraoperative manifestation of sick sinus syndrome in an eightmonth-old boy. The analysis of published data on the management of surgical patients with sinus node dysfunction was carried out.

[1]  Brian M. Waldschmidt,et al.  Anesthesia for pediatric ophthalmologic surgery. , 2019, Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus.

[2]  L. Dunphy,et al.  Paediatric orbital trapdoor fracture misdiagnosed as a head injury: a cautionary tale! , 2019, BMJ Case Reports.

[3]  R. Arnold,et al.  The oculocardiac reflex and depth of anesthesia measured by brain wave , 2019, BMC Anesthesiology.

[4]  K. Reddy,et al.  Trigeminocardiac Reflex: Case Report and Literature Review of Intraoperative Asystole in Response to Manipulation of the Temporalis Muscle. , 2019, World neurosurgery.

[5]  Seong-Hyop Kim,et al.  Intraoperative management of critical arrhythmia , 2017, Korean journal of anesthesiology.

[6]  Y. Yamane,et al.  Cardiac arrest after thoracic paravertebral block with ropivacaine in a 6-year-old child , 2015, JA Clinical Reports.

[7]  N. Mahoney,et al.  Orbital Floor Fracture with Atypical Extraocular Muscle Entrapment Pattern and Intraoperative Asystole in an Adult , 2015, Craniomaxillofacial trauma & reconstruction.

[8]  K. Kim,et al.  Profound bradycardia with lidocaine during anesthesia induction in a silent sick sinus syndrome patient. , 2011, Journal of clinical anesthesia.

[9]  J. Rivera,et al.  Arritmias intraoperatorias: nodo sinusal enfermo manifestado durante anestesia general , 2011 .

[10]  A. Hegde,et al.  Can bradycardia pose as a “red herring” in neurosurgery? Surgical stress exposes an asymptomatic sick sinus syndrome: Diagnostic and management dilemmas , 2010, Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine.

[11]  M. Manabe,et al.  Effects of sevoflurane with or without nitrous oxide on cardiac contractility and sinoatrial node rate , 1989, Journal of Anesthesia.

[12]  M. Anadón,et al.  Cardiac electrophysiological effects of remifentanil: study in a closed-chest porcine model. , 2009, British journal of anaesthesia.

[13]  Sahish Kamat,et al.  Intravenous ondansetron causing severe bradycardia: two cases. , 2009, Annals of cardiac anaesthesia.

[14]  L. Assael,et al.  A case of asystole from periorbital laceration manipulation and oculocardiac reflex in an acute trauma setting. , 2007, The Journal of trauma.

[15]  A. Shido,et al.  Prolonged cardiac arrest unveiled silent sick sinus syndrome during general and epidural anesthesia , 2007, Journal of Anesthesia.

[16]  K. Maruyama,et al.  Complete atrioventricular block during anesthesia in a patient with sick sinus syndrome under atrial pacing , 2005, Journal of Anesthesia.

[17]  P. Thistlethwaite,et al.  Dexmedetomidine and Asystole , 2004 .

[18]  V. Toprak,et al.  Anaesthetic management of severe bradycardia during general anaesthesia using temporary cardiac pacing. , 2002, British journal of anaesthesia.

[19]  O. Bagshaw,et al.  Nodal rhythm and bradycardia during inhalation induction with sevoflurane in infants: a comparison of incremental and high-concentration techniques. , 2000, British journal of anaesthesia.

[20]  T. Matsukawa,et al.  Undiagnosed sick sinus syndrome manifest during combined general and cervical epidural anesthesia , 2000, Journal of Anesthesia.

[21]  I. Broome,et al.  A comparison of the effect of rocuronium and vecuronium on heart rate during gynaecological laparoscopy , 1999, Anaesthesia.

[22]  F. Khan,et al.  Incidence of intra‐operative bradycardiaComparison of atracurium and vecuronium in gynaecological surgery , 1997, Anaesthesia.

[23]  F. Cheney,et al.  Cardiac dysrhythmias associated with the intravenous administration of ondansetron and metoclopramide. , 1997, Anesthesia and analgesia.

[24]  Moore,et al.  Propofol and bradycardia: causation, frequency and severity. , 1997, British journal of anaesthesia.

[25]  D. Hatch,et al.  Rapid inhalation induction in children: 8% sevoflurane compared with 5% halothane. , 1997, British journal of anaesthesia.

[26]  D. Levy.  Recurrent bradycardia due to latent sick sinus syndrome , 1990, Anaesthesia.

[27]  Z. Bosnjak,et al.  Mechanisms for Cardiac Dysrhythmias during Anesthesia , 1990, Anesthesiology.

[28]  C. Corr,et al.  Sick sinus syndrome manifest after spinal anaesthesia , 1989, Anaesthesia.

[29]  Z. Bosnjak,et al.  Volatile Anesthetics Attenuate Sympathomimetic Actions on the Guinea Pig SA Node , 1988, Anesthesiology.

[30]  L. I. Cohen.  Asystole during spinal anesthesia in a patient with sick sinus syndrome. , 1988, Anesthesiology.

[31]  S. Underwood,et al.  Sick sinus syndrome manifest after spinal anaesthesia , 1988, Anaesthesia.

[32]  D. Burt.  The sick sinus syndrome , 1982, Anaesthesia.

[33]  A. Reynolds,et al.  Halothane and Methoxyflurane — A Comparison of Their Effects on Cardiac Pacemaker Fibers , 1970, Anesthesiology.