en Anesthesiology Anesthesiology گزارش مورد Case report <span style="font-size:9pt"><span minion="" pro="" style="font-family:"><b>Introduction</b>: Bundle branch blocks (BBB) are usually stable and remain unchanged irrespective of the cardiac cycle length. Left bundle branch block (LBBB) usually results from conduction system degeneration or myocardial pathology. Patients with LBBB have altered patterns of left ventricular activation and contraction, causing changes in left ventricular mechanics, perfusion, and workload, leading to pathologic cardiac remodeling and heart failure over time.</span></span><br> <span style="font-size:9pt"><span minion="" pro="" style="font-family:"><b>Case Report</b><b><span style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">: </span></span></b>A 56-year-old female patient with no history of specific diseases was a candidate for lumbar vertebrae fixation surgery. The patient had no history of shortness of breath or chest pain. In clinical examination, heart rate was 75 times per minute and blood pressure was 145/95. After injection of anesthetic drugs, wide QRS waves and LBBB were observed in the patient&#39;s heart rhythm. The patient&#39;s heart rate and blood pressure increased. After the injection of lidocaine, amiodarone, and labetalol, the QRS was still widely monitored. After about 45 minutes and the patient was fully awake, suddenly the QRS and the vital signs were normalized.</span></span><br> <span style="font-size:9pt"><span minion="" pro="" style="font-family:"><b>Conclusion</b><b><span style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">: &nbsp;</span></span></b>This case highlights the need for vigilant monitoring and prompt intervention during anesthesia induction, even in the absence of known cardiac conditions.</span></span><br> &nbsp; Bundle-Branch Block, Anesthesia, Preoperative 77 82 http://jbrms.medilam.ac.ir/browse.php?a_code=A-10-962-1&slc_lang=en&sid=1 Gholamreza Hamidkholgh Gholamreza.hamidkholg@gmail.com 10031947532846008060 10031947532846008060 No Department of Emergency Medicine, School of Medicine, Ardabil University of Medical Science, Ardabil, Iran Ghodrat Akhavan-Akbari g.akhavanakbari@gmail.com 10031947532846008061 10031947532846008061 No Department of Anethesiology, School of Medicine, Ardabil University of Medical Science, Ardabil, Iran Mahzad Yousefian submit1article@gmail.com 10031947532846008062 10031947532846008062 Yes Department of Anethesiology, School of Medicine, Ardabil University of Medical Science, Ardabil, Iran