{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:39:26Z","timestamp":1787755166530,"version":"build-2784847793"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Case:<\/jats:title>\n A 42-year-old previously healthy woman developed profound hypotension, bradycardia, and asystolic cardiac arrest requiring cardiopulmonary resuscitation after an interscalene block before being placed in the beach-chair position for shoulder arthroscopy.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Activation of the Bezold-Jarisch reflex, a vagally mediated reflex leading to hypotensive bradycardic episodes, is a rare but devastating complication of shoulder arthroscopy when performed with the combination of interscalene blocks and the beach-chair position. Our case shows that the Bezold-Jarisch reflex may occur in patients before placement in the beach-chair position and may even lead to extreme reactions in healthy patients including asystolic cardiac arrest.<\/jats:p>\n <\/jats:sec>","DOI":"10.2106\/jbjs.cc.21.00079","type":"journal-article","created":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T15:01:24Z","timestamp":1629126084000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Cardiac Arrest After Interscalene Block Before Arthroscopic Shoulder Surgery"],"prefix":"10.2106","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7782-6538","authenticated-orcid":false,"given":"Jasmine A.","family":"Scott","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Naval Medical Center San Diego, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8233-4607","authenticated-orcid":false,"given":"Dustin","family":"Schuett","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Naval Medical Center San Diego, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5488-4807","authenticated-orcid":false,"given":"Niels","family":"Hauff","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Naval Medical Center San Diego, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,7]]},"reference":[{"issue":"5","key":"bib1-20240805","doi-asserted-by":"crossref","first-page":"974","DOI":"10.2106\/JBJS.D.02003","article-title":"Interscalene regional anesthesia for shoulder surgery","volume":"87","author":"Bishop","year":"2005","journal-title":"J Bone Joint Surg Am."},{"issue":"5","key":"bib2-20240805","doi-asserted-by":"crossref","first-page":"775","DOI":"10.2106\/00004623-200205000-00012","article-title":"Scalene regional anesthesia for shoulder surgery in a community setting: an assessment of risk","volume":"84","author":"Weber","year":"2002","journal-title":"J Bone Joint Surg Am."},{"issue":"6","key":"bib3-20240805","first-page":"1158","article-title":"Activation of the Bezold-Jarisch reflex in the sitting position for shoulder arthroscopy using interscalene block","volume":"80","author":"D'Alessio","year":"1995","journal-title":"Anesth Analg."},{"issue":"2","key":"bib4-20240805","first-page":"78","article-title":"Interscalene block-Potential for cardiac arrest","volume":"2","author":"Mehta","year":"2018","journal-title":"Cent J ISA."},{"issue":"5","key":"bib5-20240805","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1097\/00000542-200305000-00030","article-title":"Clinical relevance of the Bezold\u2013Jarisch reflex","volume":"98","author":"Campagna","year":"2003","journal-title":"Anesthesiology."},{"issue":"1","key":"bib6-20240805","doi-asserted-by":"crossref","first-page":"38","DOI":"10.4097\/kja.19493","article-title":"Risk factors associated with hypotensive bradycardic events during open shoulder surgery in the beach chair position","volume":"74","author":"Choi","year":"2021","journal-title":"Korean J Anesthesiol."},{"issue":"3","key":"bib7-20240805","doi-asserted-by":"crossref","first-page":"265","DOI":"10.4097\/kjae.2013.64.3.265","article-title":"A cardiovascular collapse occurred in the beach chair position for shoulder arthroscopy under general anesthesia: a case report","volume":"64","author":"Jihyun","year":"2013","journal-title":"Korean J Anesthesiol."},{"issue":"3","key":"bib8-20240805","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1213\/00000539-197705000-00029","article-title":"Cardiac arrest after interscalene brachial-plexus block","volume":"56","author":"Edde","year":"1977","journal-title":"Anesth Analg."},{"issue":"1","key":"bib9-20240805","first-page":"84","article-title":"Cardiac arrest after interscalene brachial plexus block in the sitting position for shoulder arthroscopy: a case report","volume":"70","author":"Turker","year":"2004","journal-title":"Acta Orthop Belg."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.21.00079","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:38:37Z","timestamp":1787751517000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.21.00079"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":9,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.21.00079","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7]]}}}