The severe adverse event in a locally anesthetized circumcision:  A case report of a breath-holding spell

Syifa Fauziah Fadhly; Irfan Wahyudi; Gerhard Reinaldi Situmorang; Arry Rodjani

doi:10.15562/bmj.v11i1.3379

The severe adverse event in a locally anesthetized circumcision: A case report of a breath-holding spell

Syifa Fauziah Fadhly ,

Irfan Wahyudi ,

Gerhard Reinaldi Situmorang ,

Arry Rodjani ,

pdf |
DOI: https://doi.org/10.15562/bmj.v11i1.3379 |
Published: 2022-04-11

Abstract

Introduction: Circumcision in children can be done with local anesthesia. Indifferent from other surgeries, circumcision certainly has its own risks dan complications.

Case description: A 5-month-old baby who underwent circumcision with local anesthesia was reportedly losing consciousness intraoperatively, followed by a generalized seizure. No previous medical abnormalities were known. It was thought that a breath-holding spell (BHS) was a possible etiology of this event. The patient regains consciousness after a few hours. Electroencephalogram showed normal results. BHS is a harmless condition, where it is believed that crying may cause children to be hypoxic due to prolonged breath-holding and may lead to loss of consciousness or even seizure. Patients with BHS usually recover and regain consciousness after several minutes and should not have any long-term effects after the episode.

Conclusion: Although considered a benign condition, BHS is still a frightening situation for parents and even the surgeon; thus, good communication with the patient's parents is necessary.

References

Nguyen TT, Kraft E, Nasrawi Z, Joshi M, Merianos D. Avoidance of general anesthesia for circumcision in infants under 6 months of age using a modified Plastibell technique. Pediatr Surg Int. 2019;35(5).
DiMario FJ. Breath-Holding Spells in Childhood. Am J Dis Child. 1992;146(1).
Leung AKC, Leung AAM, Wong AHC, Hon KL. Breath-Holding Spells in Pediatrics: A Narrative Review of the Current Evidence. Curr Pediatr Rev. 2018;15(1).
Abdrabou Sadek A, Mohamed Mohamed M, El-Said Ahmed Shara E-Z, Mohamed Magdy R, Ahmed Allam A. Clinico-laboratory profile of breath-holding spells in children in Sohag University Hospital, Upper Egypt. Electron physician. 2016;8(4).
To D, Kossintseva I, De Gannes G. Lidocaine contact allergy is becoming more prevalent. Dermatologic Surg. 2014;40(12).

[1] Nguyen TT, Kraft E, Nasrawi Z, Joshi M, Merianos D. Avoidance of general anesthesia for circumcision in infants under 6 months of age using a modified Plastibell technique. Pediatr Surg Int. 2019;35(5).

[2] DiMario FJ. Breath-Holding Spells in Childhood. Am J Dis Child. 1992;146(1).

[3] Leung AKC, Leung AAM, Wong AHC, Hon KL. Breath-Holding Spells in Pediatrics: A Narrative Review of the Current Evidence. Curr Pediatr Rev. 2018;15(1).

[4] Abdrabou Sadek A, Mohamed Mohamed M, El-Said Ahmed Shara E-Z, Mohamed Magdy R, Ahmed Allam A. Clinico-laboratory profile of breath-holding spells in children in Sohag University Hospital, Upper Egypt. Electron physician. 2016;8(4).

[5] To D, Kossintseva I, De Gannes G. Lidocaine contact allergy is becoming more prevalent. Dermatologic Surg. 2014;40(12).

The severe adverse event in a locally anesthetized circumcision: A case report of a breath-holding spell

Abstract

References

How to Cite

Search Panel