Home | | Clinical Cases in Anesthesia | What is the Bezold-Jarisch reflex?

Chapter: Clinical Cases in Anesthesia : Brachial Plexus Anesthesia

What is the Bezold-Jarisch reflex?

Mechanoreceptors in the left ventricle activate inhibitory vagal afferents to increase sympathetic tone and guard the body against hypotension.

What is the Bezold-Jarisch reflex?

 

Mechanoreceptors in the left ventricle activate inhibitory vagal afferents to increase sympathetic tone and guard the body against hypotension. This protective physiologic response occurs during times of severe stress, such as hemorrhage. The Bezold-Jarisch reflex is a para-doxical activation of these left ventricular receptors by a decrease in venous return, causing a decrease in sympa-thetic tone with an increase in vagal outflow. This pro-duces severe bradycardia and hypotension, which can lead to asystole.

 

Patients undergoing shoulder repair are at risk for acti-vating this reflex. The “beach chair” position causing pool-ing of blood in the lower extremities, patient anxiety and the addition of epinephrine to the arthroscopy infusate are all factors contributing to this phenomenon.

 

Ephedrine is the treatment of choice because it has a direct action on the heart and peripheral activation of cat-echolamines. Fluid resuscitation is important to prevent further stimulation of these receptors. If progression to asystole occurs, epinephrine is essential. Atropine will not adequately treat this event, should it occur.

 

 

Study Material, Lecturing Notes, Assignment, Reference, Wiki description explanation, brief detail
Clinical Cases in Anesthesia : Brachial Plexus Anesthesia : What is the Bezold-Jarisch reflex? |


Privacy Policy, Terms and Conditions, DMCA Policy and Compliant

Copyright © 2018-2024 BrainKart.com; All Rights Reserved. Developed by Therithal info, Chennai.