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

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.