Asystole following laryngoscopy and endotracheal intubation: a case report

Severe bradycardia and asystole are very rare complications following laryngoscopy and endotracheal intubation. In this report, we describe a case in which these life-threatening complications occurred in a healthy male during induction of general anaesthesia. Activation of vagal reflexes during manipulation of the airway and the use of vagotonic drugs at induction are the mechanisms postulated to be responsible for these phenomena. Analysis of heart rate variability measurements may be useful in identifying patients at risk for development of these haemodynamic alterations during the induction of anaesthesia so that appropriate drugs and monitoring can be administered.