A case of sudden occurrence of complete left bundle branch block during emergency surgery

Koichi Yamashita, Takeshi Yokoyama, Tomoki Nishiyama, Hidehiro Abe, Mizue Ito, Masanobu Manabe

Research output: Contribution to journalArticle

1 Citation (Scopus)


We experienced a case of sudden occurrence of complete left bundle branch block during emergency surgery. A 59-year-old man suffered from facial bone fracture and eye ball injury. Repair of facial bone and removal of eye ball surgery were scheduled. Chest X-ray, echocardiography, blood counts and laboratory data were within normal limits. Awake intubation was performed. Anesthesia was maintained with 2-3% sevoflurane in 1 l · min-1 of oxygen and 2 l · min-1 of nitrous oxide. After induction of anesthesia, tracheostomy was performed with combined use of local anesthesia with 6 ml of 1% lidocaine with 1/200000 epinephrine. Then removal of eye ball surgery was started and finished uneventfully. During repair of facial bone fracture, we found an unexpected complete left bundle branch block. After rapid infusion of 1000 ml acetic Ringer's solution, the complete left bundle branch block disappeared. After surgery, mannitol administration at the previous hospital was noticed. Complete left bundle branch block in this case might have been induced by hypovolemia and hyperpotassemia due to osmotic diuresis by mannitol.

Original languageEnglish
Pages (from-to)206-208
Number of pages3
JournalJapanese Journal of Anesthesiology
Issue number2
Publication statusPublished - Feb 2006
Externally publishedYes


All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

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