A Case of Cardiac Arrest During Parotidectomy Surgery

Abstract

Introduction: Sudden brady-arrhythmias during anaesthesia can be life threatening. Bradycardia and asystole have been reported during Maxillofacial surgeries due to tri-gemino-cardiac reflex. We report a case of a rare complication of asystole following dissection and handling of deep lobe of parotid gland during total parotidectomy under general anaesthesia. Case Presentation: A 70-year-old, 82 kgs, normotensive female scheduled for total left parotidectomy for tumor excision with nerve monitoring under general anaesthesia developed severe bradyarrhythmia soon progressing to asystole; 85 mins into surgery during dissection of deep lobe of parotid possibly due to tri-gemino-cardiac reflex. Conclusion: We present this case of asystole during parotidectomy to demonstrate the significance and possible severity of the reflex bradycardic response during surgical handling of deep lobe of parotid gland. Keywords: Cardiac arrest, Parotidectomy, Resuscitation, General anaesthesia, Nerve monitoring.