Satoh Jun-ichi, Arakawa Johji, Ohmori Hideya, Takahashi Hiromi, Yamakage Michiaki, Namiki Akiyoshi
Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo 060-8543.
Masui. 2006 Apr;55(4):460-3.
A 55-year-old man with no past history of ischemic heart disease underwent open reduction and internal fixation of the right arm because of an open fracture. Under general anesthesia with brachial plexus block, the operation was started after the upper arm had been pressurized at 280 mmHg by tourniquet. The patient had cardiac arrest 15 min after the tourniquet release, and was resuscitated by CPR. Postoperative intracoronary infusion of acetylcholine revealed that the coronary artery is sensitive to the agent, indicating that the intraoperative cardiac arrest might have been due to coronary vasospasm. Although the similar case is rare, attention should be taken during the anesthetic management with the use of tourniquet.
一名无缺血性心脏病病史的55岁男性因开放性骨折接受了右臂切开复位内固定术。在臂丛神经阻滞全身麻醉下,使用止血带将上臂加压至280 mmHg后开始手术。止血带松开15分钟后患者发生心脏骤停,并通过心肺复苏术复苏。术后冠状动脉内注入乙酰胆碱显示冠状动脉对该药物敏感,表明术中心脏骤停可能是由于冠状动脉痉挛所致。虽然类似病例罕见,但在使用止血带的麻醉管理过程中应予以注意。