Case report of cardiac arrest during carotid body tumor resection

Abstract We report a case of 30-second cardiac arrest that occurred during carotid body tumor resection due to the carotid sinus reflex. The patient was a 20-year-old man diagnosed with a carotid body tumor and scheduled for tumor resection. General anesthesia was induced and maintained with target controlled infusion of propofol. Analgesia was achieved with continuous administration of remifentanil. When the surgery was initiated, 1% lidocaine 3 ml was locally injected into the carotid bifurcation. When surgery was initiated in the neck region, the patient developed sudden cardiac arrest. Chest compression was immediately initiated, and atropine 0.5 mg was administered; subsequently circulation was restored. Surgery was resumed after placing a temporary pacemaker through the left subclavian vein. The surgery was successfully performed without any other bradycardia complications, and the patient recovered from general anesthesia without sequelae. Thus, the findings indicate the importance of considering the pacemaker placement before carotid body tumor resection.