• A&A practice · Apr 2021

    Case Reports

    Cardiac Arrest due to Failed Pacemaker Capture After Peripheral Nerve Blockade With Levobupivacaine: A Case Report.

    • Asuka Kitajima, Takeshi Nakatomi, Yuji Otsuka, Masamitsu Sanui, and Alan Kawarai Lefor.
    • From the Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan.
    • A A Pract. 2021 Apr 1; 15 (4): e01445e01445.

    AbstractWe describe a patient with a pacemaker who developed cardiac arrest shortly after ultrasound-guided rectus sheath block for postoperative analgesia. The cause of cardiac arrest was capture failure due to an increased pacing threshold, and the patient was promptly treated by increasing the pacing amplitude. Local anesthetics used for rectus sheath block might have affected the pacing threshold and caused pacing capture failure, since local anesthetics can block cardiac sodium channels. Anesthesiologists should recognize the risk of pacemaker capture failure when a large amount of local anesthetic is given to patients with a cardiac pacemaker.Copyright © 2021 International Anesthesia Research Society.

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