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BMC Anesthesiology
Published in: BMC Anesthesiology 1/2015

Open Access 01-12-2015 | Case report

A case of asystole from carotid sinus hypersensitivity during patient positioning for thyroidectomy

Authors: Emmanuel Lilitsis, Alexia Papaioannou, Aikaterini Hatzimichali, Konstantinos Spyridakis, Sofia Xenaki, George Chalkiadakis, Emmanuel Chrysos

Published in: BMC Anesthesiology | Issue 1/2015

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Abstract

Background

We present a case of a patient with multinodular goiter disease who suffered asystole during head hyperextension for surgical positioning on the operational table.

Case Presentation

Manipulation of carotid sinus may trigger bradycardia or even asystole even in patients without prior history of carotid sinus hypersensitivity. The time proximity between patient positioning and asystole, the late responsiveness to atropine, the immediate increase of heart rate after head elevation and the lack of any other trigger factor or prior history support the hypothesis of carotid sinus syndrome.

Conclusions

Head hyperextension during surgical positioning is not only responsible for jeopardizing blood flow to spinal cord and brainstem but may trigger reflexes, as well, even in patients without prior neck pathology.
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Metadata
Title
A case of asystole from carotid sinus hypersensitivity during patient positioning for thyroidectomy
Authors
Emmanuel Lilitsis
Alexia Papaioannou
Aikaterini Hatzimichali
Konstantinos Spyridakis
Sofia Xenaki
George Chalkiadakis
Emmanuel Chrysos
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2015
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-016-0255-5

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