[Two episodes of cardiac arrest in a boy receiving sclerotherapy with polydocanol--a case report]

A 4-year-old boy, weighing 15.6 kg, experienced two episodes of cardiac arrest during the eight sessions of sclerotherapy under general anesthesia. Although cardiac arrest had been documented after accidental extubation during the seventh procedure, the specific cause had not been identified. For the eighth procedure, anesthesia was again induced and maintained with nitrous oxide and sevoflurane. A total of 10 ml of 3% polydocanol was injected. Approximately five minutes after the injection, his heart rate slowed and asystole developed. External cardiac massage was started immediately and atropine was injected intravenously. His heart started to beat again very soon. From the clinical course, the two episodes of cardiac arrest could be attributable to polydocanol overdose. It was concluded that severe circulatory derangement might follow an injection of polydocanol during sclerotherapy.