口腔癌の術中に完全房室ブロックを生じた１例

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  • A Case of Complete Atrioventricular Block during Oral Surgery.

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A Case of complete atrioventricular block was experienced during operation under general anesthesia. The patient was a 60-year-old male who had oral floor cancer and a past history of unstable angina but the clinical course was under a sufficient observation. 100 mg of thiopental sodium and 7mg of Vb were used for induction therapy and 4:2 nitrous oxide, 0.5% of isoflurane, 0.4mg of fentanyl citrate, and 10mg of droperidol were used for the maintenance therapy. Immediately after the operation was initiated, the blood pressure and pulse dropped to the level of 50/30mm Hg and 30 beats/minute, respectively. On the ECG, total atrioventricular block was seen. When intravenous injection of 1mg of atropine sulfate, 40mg of ephedrine hydrochloride, and 3mg of epinephrine as well as heart massage were initiated, total atrioventricular block disappeared along with the increase in the blood pressure and pulse; nevertheless, the operation was discontinued for fear of recurrence.<BR>As for the cause, it was thought that something induced the spasm of the right coronary artery which lead to ischemia of the atrioventricular nodule and subsequent complete atrioventricular block.

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