一名儿茶酚胺能多形性室性心动过速患儿植入植入式心脏复律除颤器时的麻醉管理：病例报告
Anesthetic management of a child with catecholaminergic polymorphic ventricular tachycardia undergoing insertion of implantable cardioverter defibrillator : a case report.
作者信息
Omiya Keisuke, Mitsui Kazuha, Matsukawa Takashi
机构信息
Department of Anesthesiology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato Chuo, Yamanashi, 409-3898, Japan.
Surgical Center, University of Yamanashi Hospital, 1110 Shimokato Chuo, Yamanashi, 409-3898, Japan.
出版信息
JA Clin Rep. 2020 Feb 26;6(1):16. doi: 10.1186/s40981-020-00322-x.
BACKGROUND
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a fatal cardiac ion channelopathy that causes sudden unexpected death in the young.
CASE PRESENTATION
The patient was a 3-year-old girl with CPVT. Insertion of an implantable cardioverter defibrillator (ICD) using epicardial pacing was scheduled. After premedication of rectal midazolam was given, general anesthesia was induced with midazolam, fentanyl, and rocuronium, and maintained with midazolam, fentanyl, remifentanil, and rocuronium. The operation was performed without any complications. Dexmedetomidine and fentanyl were continuously infused after the operation until she was extubated in the morning of postoperative day 1. Fatal arrhythmia due to perioperative stress did not occur.
CONCLUSIONS
We report the anesthetic management of a child with CPVT who underwent insertion of an ICD. CPVT-induced fatal arrhythmia did not occur perioperatively by carefully avoiding perioperative stress with premedication and post-operative sedation.
背景
儿茶酚胺能多形性室性心动过速（CPVT）是一种致命的心脏离子通道病，可导致年轻人意外猝死。
病例报告
该患者为一名患有CPVT的3岁女孩。计划通过心外膜起搏植入植入式心脏复律除颤器（ICD）。给予直肠咪达唑仑进行术前用药后，用咪达唑仑、芬太尼和罗库溴铵诱导全身麻醉，并用咪达唑仑、芬太尼、瑞芬太尼和罗库溴铵维持麻醉。手术过程中未出现任何并发症。术后持续输注右美托咪定和芬太尼，直到术后第1天早晨拔管。未发生因围手术期应激导致的致命性心律失常。
结论
我们报告了一名接受ICD植入术的CPVT患儿的麻醉管理情况。通过术前用药和术后镇静仔细避免围手术期应激，围手术期未发生CPVT诱发的致命性心律失常。
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