Potential Bezold-Jarisch reflex secondary to a 180° postural change in an anaesthetized dog

Successful Cardiopulmonary Resuscitation in a Sevoflurane Anaesthetized Horse That Suffered Cardiac Arrest at Recovery

“…Second, a cardiac reflex following a postural change could be considered in this case. Severe cardiovascular depression in similar circumstances has been reported in a dog ( 12 ) and in humans ( 13 , 14 ). In this case, the horse experienced a rapid postural change for its transfer to the recovery box.…”

Successful cardiopulmonary resuscitation in an adult horse following cardiovascular collapse on recovery from general anaesthesia in the Trendelenburg position

“…The Bezold-Jarisch reflex (BJR) has been suggested as the cause of an acute hypotension and bradycardic episode in a dog during a postural change from dorsal to sternal (Mcmillan et al 2012) and in a person from supine to right lateral position (Kim et al 2014). The BJR is a type of neurogenic-cardiac reflex, also known as a vasovagal reflex promoting parasympathetic activity, and is characterised by a period of hypotension, bradycardia and apnoea (Hofmeister et al 2005;McMillan et al 2012) resulting from chemical or mechanical stimuli. A number of inciting causes have been documented in humans including haemorrhage, orthostasis, compression of the inferior vena cava and regional spinal anaesthesia (Kinsella and Tuckey 2001).…”

“…In our case, it is possible that an appropriate MAP was detected cranially, whilst a caudal hypotension went undetected; thus, a rapid transition to a level plane may have induced a marked systemic change in MAP inducing a BJR type reflex. Alternatively, a BJR type reflex may have occurred as a result of hypercapnia due to hypoxaemia following weaning of the mare from the ventilator by reduction of minute volume coupled with spontaneous respiration of room air during transfer to the recovery box (McMillan et al 2012).…”