Abstract
The patient was a 77-year-old woman. Emergent laparotomy was scheduled for recurrent bowel obstruction. General anesthesia combined with epidural anesthesia was administered. Epidural catheter was inserted at T10-11, and general anesthesia was induced with propofol and fentanyl. After induction, the Sellick maneuver was performed to avoid aspiration pneumonitis. But, after the Sellick maneuver, her heart rate suddenly decreased to 40 beats/min and cardiac arrest was observed for about 8 seconds. After the discontinuation of Sellick maneuver, her heart beat recovered immediately. Because the hemodynamic state was stable without administration of the catecholamine, the surgery was performed.
During the induction of general anesthesia with propofol and fentanyl, we should consider cardiac arrest due to vagal reflex induced by Sellick maneuver stimulating the superior laryngeal nerve.
