Key result
An interscalene block before placement in the beach-chair position for shoulder arthroscopy triggered the Bezold-Jarisch reflex, leading to asystolic cardiac arrest in a healthy 42-year-old woman.
Case Report (n=1)
The Bezold-Jarisch reflex can cause extreme reactions, including asystolic cardiac arrest, in healthy patients receiving an interscalene block before placement in the beach-chair position for shoulder arthroscopy.
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Clinicians should anticipate Bezold-Jarisch reflex during interscalene block in beach-chair position; case report leaves open incidence and prevention strategies.
CASE: A 42-year-old previously healthy woman developed profound hypotension, bradycardia, and asystolic cardiac arrest requiring cardiopulmonary resuscitation after an interscalene block before being placed in the beach-chair position for shoulder arthroscopy. CONCLUSION: Activation of the Bezold-Jarisch reflex, a vagally mediated reflex leading to hypotensive bradycardic episodes, is a rare but devastating complication of shoulder arthroscopy when performed with the combination of interscalene blocks and the beach-chair position. Our case shows that the Bezold-Jarisch reflex may occur in patients before placement in the beach-chair position and may even lead to extreme reactions in healthy patients including asystolic cardiac arrest.
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Scott et al. (2021) conducted a case report in Cardiac arrest / Bezold-Jarisch reflex (n=1). Interscalene block before beach-chair position was evaluated on Cardiac arrest. An interscalene block before placement in the beach-chair position for shoulder arthroscopy triggered the Bezold-Jarisch reflex, leading to asystolic cardiac arrest in a healthy 42-year-old woman.
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