Temporary cardiac arrest in patient under robotically assisted total thyroidectomy causing carotid sinus...

Area of Science:

• Cardiology
• Anesthesiology
• Endocrinology

Background:

• Carotid sinus hypersensitivity (CSH) involves an exaggerated baroreceptor reflex response.
• Manifestations include bradycardia, hypotension, and syncope.
• CSH can pose risks during surgical procedures requiring neck manipulation.

Purpose of the Study:

• To report a case of CSH during robotically assisted endoscopic total thyroidectomy.
• To highlight the successful management of CSH with atropine.

Main Methods:

• A 31-year-old female underwent robotically assisted endoscopic total thyroidectomy.
• Anesthesia was induced without incident.
• Cardiac arrest occurred during thyroid dissection, and atropine was administered.

Main Results:

• Sudden cardiac arrest occurred during the procedure.
• Atropine administration rapidly restored normal sinus rhythm.
• No further bradycardia or hypotension was observed post-atropine administration until surgery completion.

Conclusions:

• CSH can precipitate cardiac arrest during thyroidectomy.
• Atropine is an effective treatment for CSH-induced cardiac events.
• This case underscores the importance of recognizing and managing CSH in surgical settings.