Zaballos García M, Almendral Garrote J, Navia Roque J
Hospital General Universitario Gregorio Marañón, Madrid.
Rev Esp Anestesiol Reanim. 2005 May;52(5):276-89; quiz 289-90, 294.
Cardiac arrhythmias are a common complication of surgery and anesthesia. They are more likely to occur in patients with heart disease and the presence of a transitory imbalance can supply the underlying substrate for reentry, triggered activity, or abnormal automaticity. The physiologic impact of a given arrhythmia depends on its duration, on ventricular response, and on the underlying cardiac disease. Optimal management of arrhythmias in the anesthetized patient will depend on knowledge of the trigger mechanisms, the effects of anesthetic drugs on cardiac electrophysiology, and situations that favor arrhythmias. The anesthesiologist must cope with a plethora of problems related to the patient's clinical state and the trauma of surgical manipulation. Experience with electrocardiography and the application of various devices (pacemakers, cardioverters, implantable defibrillators) and knowledge of the pharmacodynamics and pharmacokinetics of new intravenous drugs will be essential for patient management. The purpose of the present review is to provide the anesthesiologist with an overview of current views on the diagnosis and management of arrhythmias during anesthesia.
心律失常是手术和麻醉常见的并发症。它们更易发生于患有心脏病的患者，短暂的失衡状态可成为折返、触发活动或异常自律性的潜在基础。特定心律失常的生理影响取决于其持续时间、心室反应以及潜在的心脏疾病。麻醉患者心律失常的最佳管理取决于对触发机制的了解、麻醉药物对心脏电生理学的影响以及易引发心律失常的情况。麻醉医生必须应对与患者临床状态及手术操作创伤相关的诸多问题。心电图经验以及各种设备（起搏器、心脏复律器、植入式除颤器）的应用，还有新型静脉药物的药效学和药代动力学知识对于患者管理至关重要。本综述的目的是为麻醉医生提供有关麻醉期间心律失常诊断和管理的当前观点概述。
