Division of Oral and Maxillofacial Surgery and Dental Anesthesiology, The Ohio State University, Columbus, Ohio.
College of Dentistry, The Ohio State University, Columbus, Ohio.
Anesth Prog. 2021 Mar 1;68(1):38-44. doi: 10.2344/anpr-67-03-08.
There are numerous causes of cardiac arrest in the perioperative period, including hypoxia, hypovolemia, and vagal response to medications or procedures during routine anesthetics. Initiation of adequate cardiopulmonary resuscitation, administration of epinephrine, and application of a defibrillator, with shocking when applicable, are all essential steps in achieving return of spontaneous circulation. Knowledge and utilization of monitoring equipment can alert the provider to problems leading to cardiac arrest as well as ensure proper resuscitative efforts during the event. Polypharmacy is quite common with many of today's special needs patients. It is important to understand the medications they are taking as well as the potential interactions that may occur with drugs given during sedation and general anesthesia. The following is a case report of cardiac arrest including asystole and pulseless electrical activity in a 27-year-old man with autism and behavioral problems who presented for restorative dentistry under general anesthesia in the ambulatory surgery setting.
围手术期引起心跳骤停的原因有很多,包括缺氧、血容量不足、麻醉期间常规用药或操作引起的迷走神经反应。充分实施心肺复苏、给予肾上腺素、应用除颤器(有电击指征时应用),这些都是实现自主循环恢复的关键步骤。对监护设备的了解和使用可以提醒医护人员注意导致心跳骤停的问题,并确保在事件发生期间进行适当的复苏努力。目前,许多特殊需求患者都需要使用多种药物,了解他们正在服用的药物以及镇静和全身麻醉期间给予的药物可能发生的潜在相互作用非常重要。以下是一个病例报告,一名 27 岁的自闭症伴行为问题男性患者在日间手术环境下全身麻醉下接受修复牙科治疗时出现心跳骤停,包括心搏停止和无脉电活动。