Fujino Y, Kishi Y, Kashihara H, Kuroda S, Aoki M, Nishio M, Mima T
Department of Anesthesia, Osaka Prefectural Hospital.
Masui. 1994 Nov;43(11):1754-7.
Anesthetic management of patients with dilated cardiomyopathy (DCM) was analyzed. From January 1991 to June 1993, we had 7 patients with DCM; 5 patients received general anesthesia and 2 patients received spinal anesthesia. General anesthesia was induced and maintained generally with diazepam and fentanyl. There were two patients who suffered from intraoperative arrhythmia. One patient who received spinal anesthesia suffered from ventricular fibrillation suddenly before the operation and we performed cardiopulmonary resuscitation successfully but the operation was cancelled. One patient who underwent emergency operation for gastric perforation suffered supraventricular tachycardia during the operation, and we were required to use antiarrhythmic agent that was thought to be deleterious to cardiac function. There was no patient who died perioperatively. There was one patient in the group IV of classification of Inoh which predicts the highest risk of dying from cardiac failure. In conclusion, it is important to control arrhythmia during the management of patients with DCM under anesthesia.
对扩张型心肌病（DCM）患者的麻醉管理进行了分析。1991年1月至1993年6月，我们有7例DCM患者；5例接受全身麻醉，2例接受脊髓麻醉。全身麻醉一般用安定和芬太尼诱导和维持。有2例患者术中出现心律失常。1例接受脊髓麻醉的患者在手术前突然发生心室颤动，我们成功进行了心肺复苏，但手术取消。1例因胃穿孔接受急诊手术的患者在手术期间出现室上性心动过速，我们需要使用被认为对心脏功能有害的抗心律失常药物。围手术期无患者死亡。在预测死于心力衰竭风险最高的Inoh分类的IV组中有1例患者。总之，在麻醉下管理DCM患者时控制心律失常很重要。
