A Fall in Ventricular Fibrillation Just after Skin Incision in a Hemodialysis-patient.
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- HIRATA Takao
- Department of Anesthesia, Kurashiki Central Hospital
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- MATSUDA Norimasa
- Department of Anesthesia, Kurashiki Central Hospital
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- TAMURA Takashi
- Department of Anesthesia, Kurashiki Central Hospital
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- MASUDA Naoki
- Department of Anesthesia, Kurashiki Central Hospital
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- YAMASHITA Shigeki
- Department of Anesthesia, Kurashiki Central Hospital
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- YONEI Akitomo
- Department of Anesthesia, Kurashiki Central Hospital
Bibliographic Information
- Other Title
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- 人工透析患者における手術開始直後に心室細動をきたした1例
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Abstract
We report intraoperative cardiac arrest in a patient who was medicated by antiarrhythmic drugs. A 70-year-old male was scheduled for amputation of necrotic digiti pedeis due to arteriosclerosis obliterans. He takes daily pirmenol for premature ventricular contractions (PVC), and undergoes hemodialysis three days a week.<br>Anesthesia was induced with thiamylal, fentanyl, and vecuronium and maintained with nitrous oxide (60%), oxygen (40%) and sevoflurane (1-3%). After inducing of anesthesia, his serum potassium level was 2.4mEq•l-1. Five minutes after the start of surgery, several PVC appeared and there was a drop in ventricular fibrillation (Vf). After immediate cardiopulmonary resuscitation and countershock, sinus rhythm was restored within approximately five minutes.<br>In this case, triggered activity, a factor in life-threatening arrhythmia, was induced by interaction with pirmenol and hypokalemia, and additively an insufficient depth of anesthesia brought PVC to Vf.<br>It was considered that the class Ia antiarrhythmic drug should be reduced before surgery under general anesthesia for the hemodialysis patient, and that hypokalemia should be avoided.
Journal
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- THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA
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THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA 21 (3), 165-169, 2001
THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA
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Keywords
Details 詳細情報について
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- CRID
- 1390282679736288000
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- NII Article ID
- 130003581806
- 10010154589
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- NII Book ID
- AN00330159
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- ISSN
- 13499149
- 02854945
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- Text Lang
- ja
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- Data Source
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- JaLC
- Crossref
- CiNii Articles
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- Abstract License Flag
- Disallowed