Year : 2023  |  Volume : 17  |  Issue : 1  |  Page : 80-82

Severe bradycardia and hypotension induced by autonomic neuropathy in a diabetic patient during general anesthesia – A case report

Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea

Correspondence Address:
Hyuckgoo Kim
Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Hyeonchung-ro, 170, Nam-gu, Daegu, 705-703
Republic of Korea
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sja.sja_502_22

Rights and Permissions

Cardiovascular autonomic neuropathy (CAN) is characterized by dysregulation of sympathetic and parasympathetic nervous systems that causes cardiovascular and respiratory disorders. The number of diabetic patients undergoing surgery is increasing in line with the prevalence of DM. Anesthesiologists should pay attention to diabetic patients with CAN because it is related to serious cardiovascular morbidity and mortality. We report an 80-year-old male who underwent cervical laminoplasty. He had severe bradycardia and hypotension from induction to the suspension of surgery. His blood pressure dropped to 70/40 mmHg and his heart rate to 20 bpm. Ephedrine, phenylephedrine, and atropine administration had minimal effect, but after epinephrine administrations, his heart rate and blood pressure increased to 70 bpm and 170/90 mmHg. The operation was discontinued because of the patient's unstable, fluctuating vital signs. The results of autonomic nervous system function examination indicated postganglionic cholinergic sympathetic dysfunction, sympathetic adrenergic dysfunction, and parasympathetic cholinergic dysfunction.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded57    
    Comments [Add]    

Recommend this journal