Post-operative apnoea caused by breath-holding spells

After recovery from anaesthesia for a urological procedure a two-and-a-half-year-old child with a history of breath-holding spells became apnoeic and cyanotic in the immediate post-operative period. The pathophysiology of breath-holding as the cause of the apnoea is discussed. Management includes ventilation with oxygen and avoidance of inappropriate treatment with drugs to reverse muscle relaxants or narcotic anesthetics.