Complete Heart Block After Administration of Intravenous Pethidine

Pethidine is used by anesthesiologists to provide pain relief during the perioperative period, labor, and trauma, but it is not frequently used nowadays because of the availability of more potent shorter‑acting opioids. But even today it is commonly used by many to alleviate shivering in surgical patients. Because of these actions on the autonomic nervous system, pethidine may produce changes in the heart rate in combination with other medications or interventions. We encountered ill‑sustained complete heart block in a patient who received 25 mg pethidine intravenously to alleviate shivering. No other treatment except 0.2 mg glycopyrrolate was required as the patient had hemodynamic stability.