Cardiac arrest due to a vagal reflex potentiated by thoracic epidural analgesia

J. Y. Park, S. J. Park, J. Y. Kim, H. W. Shin, H. J. Lim, J. Kim

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


Reflex bradycardia and cardiac arrest may be the result of a vagal reflex, which can occur during a variety of surgical procedures. We report a patient who developed cardiac arrest as a result of a vagal reflex that was potentiated by thoracic epidural analgesia during general anaesthesia. A 53-year-old man was scheduled for subtotal gastrectomy because of an early gastric adenocarcinoma. After an epidural catheter had been inserted, general anaesthesia was induced. During surgery, an abdominal self-retaining retractor was set up but bradycardia and cardiac arrest developed. The patient returned to a normal sinus rhythm after successful resuscitation. We conclude that bradycardia as a result of a vagal reflex is mediated by potent abdominal wall traction and is potentiated by epidural analgesia. Early diagnosis and proper treatment can allow a full recovery, even in high-risk patients.

Original languageEnglish
Pages (from-to)433-436
Number of pages4
JournalJournal of International Medical Research
Issue number4
Publication statusPublished - 2006


  • Cardiac arrest
  • Epidural analgesia
  • Vagal reflex

ASJC Scopus subject areas

  • Biochemistry
  • Biochemistry, medical
  • Cell Biology


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