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이수경 ( Soo Kyung Lee ),조정훈 ( Jeonghoon Cho ),김남현 ( Namhyun Kim ),박성혁 ( Seonghyeok Park ),문현수 ( Hyun Soo Moon ) 경희대학교 경희의료원 2023 慶熙醫學 Vol.38 No.1
Laparoscopic surgery is frequently used in various surgical procedures. The artificial pneumoperitoneum using carbon dioxide is an essential element in laparoscopic surgery. However, intra-abdomonal insufflation stretches the peritoneum, which increases vagal tone and can lead to life-threatening bradyarrhythmias including asystole. We report two cases of severe bradycardia and impending cardiac arrest at the beginning of peritoneal insufflation in patients undergoing laparoscopic surgery. In first case, we performed cardiopulmonary resuscitation with external cardiac compression and epinephrine administration to prevent progressing into cardiac arrest. In second case, we used atropine while deflating the abdomen. The patients were recovered without any problem. Anesthesiologists should be aware of the potential for this critical complication.