Heart block following propofol in a child

We present the case of a nine-year-old boy afflicted with Ondine's curse, w ho developed complete atrioventricular heart block after a single bolus of propofol for induction of anaesthesia for strabismus surgery. Ondine's curs e, the other name for congenital central hypoventilation syndrome, is chara cterized by a generalized disorder of autonomic function. Propofol has no e ffect on the normal atrioventricular conduction system in humans but it red uces sympathetic activity and can highly potentiate other vagal stimulation factors. Heart block has been documented after propofol bolus use in adult s but, to our knowledge, not in children. It would appear that propofol is not a good choice for anaesthesia in congenital central hypoventilation syn drome.