Department of Anesthesiology and Pain Medicine, College of Medicine, Hanyang University, Guri, Korea.
Korean J Anesthesiol. 2013 Mar;64(3):265-7. doi: 10.4097/kjae.2013.64.3.265. Epub 2013 Mar 19.
The occurrence of severe hypotension and bradycardia, following placing to the beach chair position from supine during general anesthesia for repair of tendon injury of the rotator cuff of shoulder in a healthy 50 year-old man was described. The Bezold-Jarisch reflex, which is known to inhibit cardiovascular reflex and composed of three kinds of symptoms such as vasodilation, bradycardia and hypotension, has been reported mainly in peripheral nerve block, and may occur during orthostasis, hypovolemia, hemorrhage, supine inferior vena cava compression in pregnancy, interscalene block for shoulder surgery in the sitting position and so on. The bradycardia and hypotension can be more aggravated when causative elements overlaps each other. Anticholinergics and vasopressor were injected intravenously, and position of the patient was changed to the supine position immediately resulting in a normal vital signs dramatically.
在对一位健康的 50 岁男性进行全身麻醉修复肩袖肌腱损伤时，患者从仰卧位转为沙滩椅位后出现严重低血压和心动过缓。众所周知，贝佐尔德-贾里希反射可抑制心血管反射，由血管扩张、心动过缓和低血压三种症状组成，主要发生在外周神经阻滞时，可能发生在直立、血容量减少、出血、妊娠时下腔静脉受压、坐位肩部手术的肌间沟阻滞等情况下。当致病因素重叠时，心动过缓和低血压可能会加重。静脉注射了抗胆碱能药物和血管加压素，患者立即被改为仰卧位，生命体征迅速恢复正常。
