Multiple asystole events in a patient undergoing total knee arthroplasty - a case report

BACKGROUND: Unexpected cardiac arrest in patients during surgery is associated with high mortality. Reasons are often multifactorial and unclear. CASE PRESENTATION: This case report describes a patient who developed reversible asystole during knee surgery under general anaesthesia. All diagnostic cardiac examinations were unremarkable. After surgery, the patient showed no further symptoms. CONCLUSION: To prevent cardiac arrest due to non-cardiac reasons, patients with a high risk for asystole caused by vasovagal reflex or by pain need to be identified. Preoperative conditions such as hypovolemia need to be improved prior to surgery, and additional monitoring should be used. Further investigations to determine the influence of non-cardiac disease and long-term medication are necessary.