Heart block after induction of anesthesia in a child

A case of complete heart block occurred after induction of halothane anesthesia in a previously healthy child. The patient underwent repair of an umbilical hernia under general anesthesia. After a standard halothane, nitrous oxide, and oxygen mask induction, complete heart block was noted on the electrocardiographic monitor. Atropine and 100% oxygen were administered, and sinus tachycardia resulted. With the immediate stabilization of the patient's condition, the surgical team agreed to proceed with the case. After deepening of the level of anesthesia, first with halothane and then with desflurane and easy intubation of the trachea, complete heart block again was noted. Oxygen was administered at 100%, sinus tachycardia resumed, the case was canceled, and the patient emerged from anesthesia without further incident. The patient had an uneventful recovery and was discharged to home.