PMC5818772_01
Electrocardiogram
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Fig1
A complete right bundle branch block (RBBB) was the only abnormality observed on the electrocardiogram (ECG) (Fig. 1).
Anesthetic chart
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Fig2
We then began performing assisted ventilation, which was achieved by using a face mask (Fig. 2). We immediately ceased the administration of sevoflurane and nitrous oxide and began cardiopulmonary resuscitation (CPR) with a combination of 15 chest compressions and two ventilations (Fig. 2). Throughout this incident, his SpO2 did not decrease (Fig. 2).
Electrocardiographic changes before CPR. a Initial electrocardiogram: HR=75 bpm. b Approximately one minute and few seconds after induction: HR=20 bpm. c Just before cardiopulmonary resuscitation: HR=0 bpm
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Fig3
The ECG initially showed a normal sinus rhythm (Fig. 3). However, a few seconds later, his ECG indicated severe bradycardia (HR of <30 bpm) and gradually showed prolonged R-R intervals, immediately followed by asystole (Fig. 3).
Electrocardiographic changes after CPR. a After cardiopulmonary resuscitation: HR=50 bpm. b Before leaving the operation room: HR=95 bpm
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Fig4
A few minutes after CPR, the previous chest compression waveform on the ECG changed, as the patient's heartbeat and breathing returned (Fig. 4). Thereafter, he was transported to the recovery room of the ward (Fig. 4).