Coriat P, Harari A, Ducardonet A, Tarot J P, Viars P
Br J Anaesth. 1981 May;53(5):545-8. doi: 10.1093/bja/53.5.545.
Electrocardiographic recording by Holter monitoring demonstrated the absence of any modification, however minimal, of the intranodal conduction during surgical procedures under extradural anaesthesia in 20 patients with right bundle branch block (RBBB) and left anterior hemiblock (LAHB) but without symptoms. These data suggest that extradural anaesthesia can be used safely in patients with asymptomatic chronic RBBB and LAHB without prophylactic insertion of pacemakers. However, patients having experienced either syncope or transient Mobitz II second degree AV block are likely to have a trifascicular block and increased risk of advanced heart block during extradural anaesthesia.
动态心电图监测的心电图记录显示，在20例无症状的右束支传导阻滞（RBBB）和左前分支阻滞（LAHB）患者的硬膜外麻醉手术过程中，结内传导没有任何改变，无论多么轻微。这些数据表明，硬膜外麻醉可安全用于无症状的慢性RBBB和LAHB患者，无需预防性植入起搏器。然而，曾经历过晕厥或短暂莫氏Ⅱ型二度房室传导阻滞的患者可能存在三分支阻滞，在硬膜外麻醉期间发生高度房室传导阻滞的风险增加。
