Skip to main content Skip to main navigation menu Skip to site footer

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 ,

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

  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).

How to Cite

Fadhly, S. F., Wahyudi, I., Gerhard Reinaldi Situmorang, & Arry Rodjani. (2022). The severe adverse event in a locally anesthetized circumcision: A case report of a breath-holding spell. Bali Medical Journal, 11(1), 209–210. https://doi.org/10.15562/bmj.v11i1.3379

HTML
0

Total
0

Share

Search Panel

Syifa Fauziah Fadhly
Google Scholar
Pubmed
BMJ Journal


Irfan Wahyudi
Google Scholar
Pubmed
BMJ Journal


Gerhard Reinaldi Situmorang
Google Scholar
Pubmed
BMJ Journal


Arry Rodjani
Google Scholar
Pubmed
BMJ Journal