Sinus bradycardia following saline irrigation of the pleural cavity during a video-assisted thoracoscopic surgery: A case report.

Abstract

A 43-year-old man underwent lipoma excision operation with video-assisted thoracoscopic surgery (VATS). Upon completion of the surgery, 20degrees C cold saline irrigation was performed to clean the surgical field. During this procedure, a sudden sinus bradycardia (33 beats/min) occurred. After interruption of the irrigation, the normal sinus rhythm returned spontaneously. With the suspicion that the cold saline could have induced the bradycardia, 40degrees C warm saline irrigation was performed; however, the repeat sinus bradycardia occurred again. The saline irrigation was stopped and the heart rate returned to normal. We conclude that although warm saline irrigation is a common practice after surgical procedures to ensure hemostasis and to clean the surgical field, it may induce profound sinus bradycardia.