{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T17:47:24Z","timestamp":1767030444269,"version":"3.48.0"},"reference-count":9,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T00:00:00Z","timestamp":1765843200000},"content-version":"vor","delay-in-days":168,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia Reports"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>We present the case of a 47\u2010year\u2010old man undergoing an elective laparoscopic inguinal hernia repair complicated by intra\u2010operative asystole following pneumoperitoneum and a subsequent delayed intra\u2010abdominal haemorrhage. Notably, he exhibited profound paradoxical bradycardia and hypotension in the context of significant haemorrhage, diverging from the expected tachycardic response. Management required prompt resuscitation, urgent re\u2010exploration and intensive care support. Paradoxical bradycardia presents a diagnostic challenge, as limited awareness among clinicians may confer false reassurance of haemorrhagic resolution, thereby contributing to delayed intervention. This case report seeks to underscore this uncommon deviation from the classical physiological response, with the intention of mitigating diagnostic oversight in the management of peri\u2010operative haemorrhagic shock and offers alternative clinical considerations to support early recognition.<\/jats:p>","DOI":"10.1002\/anr3.70043","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T11:12:38Z","timestamp":1765883558000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Paradoxical bradycardia as a sign of silent bleeding resulting in a pelvic haematoma after an elective hernia repair"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9639-3712","authenticated-orcid":false,"given":"C.","family":"Murphy","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology Mayo University Hospital  Castlebar Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Duggan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Mayo University Hospital  Castlebar Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,16]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15501"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7437.451"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.33963\/v.phj.101281"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/08998280.2018.1559386"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199809000-00020"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.1978.tb00051.x"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr.04.2010.2872"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.12.1.1"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/86.6.859"}],"container-title":["Anaesthesia Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.70043","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T17:42:25Z","timestamp":1767030145000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1002\/anr3.70043"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":9,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1002\/anr3.70043"],"URL":"https:\/\/doi.org\/10.1002\/anr3.70043","archive":["Portico"],"relation":{},"ISSN":["2637-3726","2637-3726"],"issn-type":[{"type":"print","value":"2637-3726"},{"type":"electronic","value":"2637-3726"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2025-12-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70043"}}