Nagasaka Yukiko, Machino Asami, Fujikake Kazuma, Kawamoto Eiji, Wakamatsu Masaki
Division of Anesthesia, Chubu Rosai Hospital, Nagoya 450-0075.
Masui. 2009 Aug;58(8):987-9.
A 64-year-old woman with hypertension, diabetes mellitus and asymptomatic first degree AV block underwent low anterior resection of the rectum. Anesthesia was induced with propofol, vecuronium bromide and remifentanil and maintained with nitrous oxide in oxygen, propofol and remifentanil. We did not use epidural anesthesia. After the operation, the patient was admitted to the intensive care unit under general anesthesia with propofol and remifentanil. In addition, dexmedetomidine was given without loading dose. The EKG changed from first degree AV block to second degree AV block followed by complete AV block and finally cardiac arrest. As soon as we performed heart massage, sinus rhythm appeared. We should be careful in giving dexmedetomidine to a patient with AV block.
一名64岁患有高血压、糖尿病且无症状一度房室传导阻滞的女性接受了直肠前切除术。麻醉诱导使用丙泊酚、维库溴铵和瑞芬太尼,维持麻醉使用笑气、氧气、丙泊酚和瑞芬太尼。我们未使用硬膜外麻醉。术后,患者在丙泊酚和瑞芬太尼全身麻醉下被收入重症监护病房。此外,未给予负荷剂量就给予了右美托咪定。心电图从一度房室传导阻滞变为二度房室传导阻滞,随后发展为完全性房室传导阻滞,最终心脏骤停。我们一进行心脏按压,窦性心律就出现了。给患有房室传导阻滞的患者使用右美托咪定时我们应谨慎。