Key result
General anesthesia with enflurane triggers intraoperative high-grade AV block reversed by glycopyrrolate during cesarean delivery.
Why the study?
Patients with pre-existing Mobitz type I second degree AV block may be at risk for development of high grade AV block during general anesthesia and surgery, but this risk is not well characterized.
Case Report (n=1)
No
Patients with pre-existing, even asymptomatic, Mobitz type I AV block may be at risk for developing high-grade AV block during general anesthesia and surgery involving vagal stimulation.
Answers are grounded in this paper and cite their sources.
May warrant vigilance for AV block progression in asymptomatic Mobitz I under anesthesia; leaves open need for prospective studies.
This report is presented in which an asymptomatic parturient with Mobitz I second degree heart block developed high grade heart block during cesarean section under general anesthesia with enflurane. Progression of the block might be associated with vagal reflex. The event in this case suggests that the patients with pre-existing heart block may be a risk factor for development of high grade atrioventricular block during general anesthesia and surgery.
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Lee et al. (2006) conducted a case report in Mobitz type I atrioventricular block (n=1). General anesthesia (enflurane) for cesarean section was evaluated on Development of high grade atrioventricular block. An asymptomatic parturient with pre-existing Mobitz type I AV block developed high-grade AV block during a cesarean section under general anesthesia with enflurane, which successfully resolved with glycopyrrolate.
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