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牙科手术期间全身麻醉引起的心律失常

Cardiac dysrhythmias with general anesthesia during dental surgery.

作者信息

Rodrigo C R

出版信息

Anesth Prog. 1988 May-Jun;35(3):102-15.

Abstract

Dysrhythmias with general anesthesia during dental surgery have been frequently reported. The incidence appears higher in spontaneously breathing patients lightly anesthetized with halothane. Anxiety, sitting posture, hypoxia, Chinese race, and heart disease appear to aggravate the condition. Use of beta blockers or lidocaine prior to anesthesia, intravenous induction, controlled ventilation with muscle relaxants, and use of isoflurane or enflurane in spontaneously breathing patients appear to decrease the incidence. It is stressed that continuous cardiac monitoring should be done in patients undergoing dental surgery under anesthesia in order to detect diagnose and treat any dysrhythmia. The great majority of dysrhythmias disappear either spontaneously or when the stimulus is stopped. In some cases there may be an obvious cause that should be immediately corrected. The need for drug intervention is rare and must be used with great care when used.

摘要

牙科手术中全身麻醉期间的心律失常已有频繁报道。在使用氟烷进行浅麻醉的自主呼吸患者中,其发生率似乎更高。焦虑、坐姿、缺氧、华裔以及心脏病似乎会加重病情。麻醉前使用β受体阻滞剂或利多卡因、静脉诱导、使用肌肉松弛剂进行控制通气,以及在自主呼吸患者中使用异氟烷或恩氟烷,似乎会降低发生率。需要强调的是,接受麻醉下牙科手术的患者应进行连续心脏监测,以便检测、诊断和治疗任何心律失常。绝大多数心律失常会自行消失或在刺激停止时消失。在某些情况下,可能存在明显的病因,应立即纠正。药物干预的需求很少,使用时必须极其谨慎。

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