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Asystole Following Jaw Thrust Maneuver: A Case Report
Jingxia Meng1, Yonggang Wang1, Mira Kehar1
1Anesthesiology, Metropolitan Hospital, New York, USA.
Cureus
|November 8, 2024
Summary
The jaw thrust maneuver, used to open airways, can rarely cause severe bradycardia and asystole due to vagal response to pain. This airway management technique may trigger an unexpected parasympathetic response in patients.
Area of Science:
- Anesthesiology
- Emergency Medicine
- Critical Care
Background:
- The jaw thrust maneuver is a critical technique for airway management in unconscious patients, primarily to prevent tongue-based airway obstruction.
- While known complications include spinal cord injury and mandibular injury exacerbation, the associated pain and potential parasympathetic responses are less frequently discussed.
Observation:
- A rare case of a healthy 38-year-old female patient experiencing transient, severe bradycardia progressing to asystole immediately after a jaw thrust maneuver during emergence from general anesthesia is presented.
- This event occurred despite the patient being otherwise healthy and the maneuver being a standard procedure.
Findings:
- The bradycardia and subsequent asystole are attributed to a potent vagal response triggered by the pain associated with the jaw thrust maneuver.
- This suggests that the parasympathetic nervous system can be significantly activated by the pain stimulus from this airway technique.
Implications:
- Clinicians should be aware of the potential for severe bradycardia and asystole as a rare complication of the jaw thrust maneuver, particularly in the context of patient pain.
- This case highlights the importance of considering vagal responses in airway management and warrants further investigation into the incidence and risk factors for such events.
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