Shiraishi M, Murayama K, Hanzawa K, Warabi K, Kamiyama Y
Juntendo University Urayasu Hospital, Department of Anesthesiology, Chiba.
Masui. 1997 Jan;46(1):114-8.
A 60-year-old man with severe DCM was scheduled for a herniorrhaphy under epidural anesthesia using fentanyl. Three months prior to operation, the patient suffered heart failure associated with life-threatening ventricular arrhythmia. The former was successfully treated with pimobendan as the main constituent of medication, but the latter was not responsive to various antiarrhythmic drugs with the exception of aprindine. On the day of operation and for two days postoperatively, pimobendan was administered daily. A sudden drop in systemic blood pressure and central venous pressure (CVP) during anesthesia, as well as the tendency to hypotensive status in the postoperative period were well regulated with continuous infusion of dopamine and dobutamine via CVP catheter probably due to the effect of up-regulation of pimobendan, together with adjustment of the volume of intravenous fluids. No dangerous ventricular arrhythmia were observed. Thereafter the patient made uneventful progress and was discharged on the 8th postoperative day.
一名60岁重度扩张型心肌病男性患者计划在硬膜外麻醉下使用芬太尼进行疝修补术。术前3个月，患者出现与危及生命的室性心律失常相关的心力衰竭。前者以匹莫苯丹作为主要药物成分成功治疗，但后者除茚满丙二胺外对各种抗心律失常药物均无反应。手术当天及术后两天，每日给予匹莫苯丹。麻醉期间全身血压和中心静脉压（CVP）突然下降，以及术后出现低血压状态的趋势，可能由于匹莫苯丹上调作用，通过CVP导管持续输注多巴胺和多巴酚丁胺，并调整静脉输液量，得到了很好的控制。未观察到危险的室性心律失常。此后患者病情平稳，术后第8天出院。
