Division of Cardiology, Shimane University Faculty of Medicine, Japan.
Intern Med. 2021 Oct 15;60(20):3257-3260. doi: 10.2169/internalmedicine.7382-21. Epub 2021 Apr 26.
An 82-year-old woman was admitted to our hospital because of dyspnea and bradycardia during exertion. Electrocardiography revealed complete atrioventricular block. During pacemaker implantation, a small dose (12.5 mg) of hydroxyzine was injected for sedation, and torsade de pointes (Tdp) occurred. The QT interval was prolonged after administration of hydroxyzine, and Tdp was observed after the R on T phenomenon occurred, indicating that hydroxyzine was capable of prolonging the QT interval and causing Tdp. Therefore, we must be cautious when administering hydroxyzine for sedation during surgery, especially in patients with bradycardia.
一位 82 岁女性因活动时呼吸困难和心动过缓而入院。心电图显示完全性房室传导阻滞。在植入起搏器时，给予小剂量（12.5 毫克）羟嗪镇静，发生尖端扭转型室性心动过速（TdP）。羟嗪给药后 QT 间期延长，在 R 波上出现 Tdp 现象后观察到 Tdp，表明羟嗪能够延长 QT 间期并导致 Tdp。因此，我们在手术中使用羟嗪镇静时必须谨慎，特别是在心动过缓的患者中。
