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[室内传导异常患者的全身麻醉(作者译)]

[General anesthesia in patients with intraventricular conduction abnormalities (author's transl)].

作者信息

Santini M, Carrara P, Benhar M, Lazzari G, Rocchi M, Dini P, Di Mascolo R, Alliegro A, Messina G, Masini V

出版信息

G Ital Cardiol. 1977;7(9):917-21.

PMID:924081
Abstract

This study was undertaken to assess the risk of developing complete heart block during general anesthesia in patients with bundle branch block. His bundle electrograms were recorded during sinus rhythm and after atrail pacing in 11 patients (5 LBBB, 2 RBBB, 3 RBBB and LAH, 1 RBBB and LBH) before and after administration of Pentothal 0.20 g e.v., Succinylcholine 1 mg/kg e.v., and breathing of fluothane 1%or Ethrane. Minimal effects on sinus functions and A-V node conduction was observed during anesthesia; Fluothane only increased slightly AH intervals (+11%). Both Fluothane and Ethrane effects on HV conduction was insignificant. In 9 patients HV intervals increased of 5% after Succinylcholine; 2 patients developed a complete heart block distal to his after the drug. Possible causes of the complete heart block are discussed and a direct effect of Succinylcholine is hypothesized.

摘要

本研究旨在评估束支传导阻滞患者在全身麻醉期间发生完全性心脏传导阻滞的风险。在11例患者(5例左束支传导阻滞、2例右束支传导阻滞、3例右束支传导阻滞合并左前分支阻滞、1例右束支传导阻滞合并左后分支阻滞)给予静脉注射0.20 g硫喷妥钠、1 mg/kg静脉注射琥珀酰胆碱并吸入1%氟烷或恩氟烷前后,于窦性心律及心房起搏后记录希氏束电图。麻醉期间观察到对窦房结功能和房室结传导的影响极小;氟烷仅使AH间期略有增加(+11%)。氟烷和恩氟烷对HV传导的影响均不显著。9例患者在使用琥珀酰胆碱后HV间期增加了5%;2例患者在用药后发生了希氏束远端的完全性心脏传导阻滞。文中讨论了完全性心脏传导阻滞的可能原因,并推测了琥珀酰胆碱的直接作用。

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