Rare procedures during delivery room resuscitation--cardioversion of ventricular tachycardia in an asphyctic neonate.

Successful cardioversion of ventricular tachycardia in a full-term male infant, born severely depressed by emergency Cesarean section 9 min after the mother was given bilateral paracervical bupivacaine blocks for pain relief during normal labor, is described. The apparently stillborn baby was resuscitated by conventional means until electronic heart monitoring revealed transition from asystole to rapid ventricular tachycardia 14 min after birth. At 20 min, cardioversion with 5 watt-second was performed with successful reversion to sinus rhythm. The child recovered rapidly and neurological status at 12 months was normal. Obviously, active search and aggressive management of rapid ventricular arrhythmias are indicated during neonatal resuscitation, if potentially arrhythmogenic drugs are used in perinatal care.